Up to 10-year follow-up of the Symax stem in THA: a Danish single-centre study

Edwards, Nina M; Varnum, Claus; Kjærsgaard‐Andersen, Per

doi:10.5301/hipint.5000578

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…The cohorts of patients of both previously mentioned studies were independent. Furthermore, a Danish single-center registry study of the Symax hip stem showed a median 6.5-year survival rate of 97.5% (95% CI 96.6-98.3%), while the overall median 6.5-year survival rate for uncemented hip stems was 95% in the same Danish registry (Edwards et al 2018). In this registry study with follow-up of up to 10 years, 29 of 1,055 hip stems were revised.…”

Section: Discussionmentioning

confidence: 65%

Early stabilization of the uncemented Symax hip stem in a 2-year RSA study

et al. 2020

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Section: Discussionmentioning

confidence: 65%

Early stabilization of the uncemented Symax hip stem in a 2-year RSA study

et al. 2020

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“…Our study population was comparable to the total group of patients with uncemented THAs in the Netherlands for age, gender distribution, and diagnosis. The cumulative revision rates are also in line with the median 6.5-year survival rates of the Symax hip stem with all-cause revision as the endpoint of 97.5% (96.6%-98.3%) in Vejle, Denmark [8]. The NICE recommends only those hip prostheses which have (projected) revision rates of 5% or less at 10-year clinical follow-up [12].…”

Section: Plos Onementioning

confidence: 70%

“…The stem showed early stabilization in 2 independent RSA studies, and excellent clinical outcomes in a 5-year clinical and radiographic follow-up study [5][6][7]. In a Danish implant registry study that included 1,055 total hip arthroplasties (THAs) in a single centre, the estimated 6.5-year survival rate of the Symax hip stem with all-cause revision as the endpoint was 97.5% (CI 96.6%-98.3%) [8]. Most common reasons for revision surgery in that study were periprosthetic fractures (n = 11) and recurrent dislocations (n = 10) [8].…”

Section: Introductionmentioning

confidence: 99%

Survival and reasons for revision of the uncemented Symax hip stem: A Dutch Arthroplasty Register study

et al. 2021

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Aims Previous studies have already shown early proximal ingrowth, fast osseous integration, and a stable fit of the uncemented Symax hip stem, with excellent clinical and radiographic performance. Aims were to evaluate cumulative revision rates and reasons for revision of the Symax hip stem using Dutch Arthroplasty Register (LROI) data and to assess possible associations between patient characteristics and revision rate of the Symax hip stem. Patients and methods All total hip arthroplasties with the uncemented Symax hip stem registered in the LROI between 2007 and 2017 were included (n = 5,013). Kaplan-Meier survival analysis was performed to assess the cumulative 1, 5 and 7-year revision percentages. Cox proportional hazard regression analysis was performed to assess the association between patient and procedural characteristics, and revision arthroplasty of the stem. Results Cumulative 1, 5, and 7-year revision rates (with 95% confidence interval (CI)) for revision of any component were 1.5% (CI 1.2%-1.8%), 3.2% (CI 2.7%-3.7%), and 3.8% (CI 3.1%-4.4%) respectively. Cumulative 1, 5, and 7-year stem revision rates of the Symax hip stem were 0.9% (CI 0.6%-1.1%), 1.5% (CI 1.1%-1.9%), and 1.7% (CI 1.3%-2.1%) respectively. Periprosthetic fractures (n = 35) and loosening of the stem (n = 30) were the most common reasons for revision of the stem. Revision of the stem was associated with acute fracture as primary diagnosis (Hazard Ratio (HR) 2.4 (CI 1.3–4.3)), or history of a previous surgery to the affected hip (HR 2.7 (CI 1.4–5.2)). Conclusion This population-based registry study shows revision rates for the Symax hip stem comparable to those for best performing uncemented total hip arthroplasties in the Netherlands. Primary diagnosis of an acute fracture, and history of previous surgery on the affected hip, were significantly associated risk factors for revision of the Symax hip stem, and we discourage the use of the Symax hip stem in these patients.

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“…Clinical studies have looked at different surgical approaches, 19 interface conditions, 20 and commercially available stem designs having different geometries, sizes, coatings, and materials. 6,17,[19][20][21][22][23][24][25][26][27][28][29][30][31] Only a few of these studies report on both tapered and cylindrical cementless implant designs for use in more challenging revision THA procedures. 6,17,23,31 From these remaining studies, different implant manufacturers were used and therefore different overall stem designs were tested.…”

mentioning

confidence: 99%

“…Despite clinical success of each of these stem designs and their wide adoption, 6,17,19,20,23,[25][26][27][28][29][30][31] a direct mechanical comparison between cylindrical and tapered stems, controlling for distal taper as a singled out implant design variable, with more severe Type III-B bone defects is lacking in the literature. Experimental studies have tested cylindrical 32,33 and compared tapered with cylindrical THA stem designs with both Type III-A 7,34 and Type III-B bone defects.…”

mentioning

confidence: 99%

Tapered stem geometry provides superior initial fixation stability to cylindrical stem geometry in the setting of severe bone loss: A finite element analysis

Kosmopoulos

Russell

Rodrigues

et al. 2020

Engineering Reports

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Initial stability of cementless stems used in total hip arthroplasty (THA) is critical for subsequent osseointegration at the bone/implant interface. In the setting of revision THA, there is frequently less intact femoral bone available for fixation of the new stem. This study aims to compare the initial fixation stability between a cylindrical and tapered stem, designed for diaphyseal fixation in a revision THA setting, with increasing bone defect severity. Using finite element analysis, severe Paprosky Type III femoral bone defects were simulated. The cylindrical stem had a 13.3% higher construct stiffness as compared to the tapered stem for the least severe bone defect modeled. In contrast, for the most severe bone defect, the tapered stem showed a 12.3% higher construct stiffness than the cylindrical stem. At the bone/implant interface, the tapered design resulted in less than 20 μm of maximum tangential micromotion for all the bone defect models, whereas the cylindrical stem exceeded 20 μm for all and was as high as 70 μm in the most severe case. Given the limitations of the models presented, the results suggest the tapered stem obtained superior initial fixation as compared to cylindrical stem with increasing bone defect severity.

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Up to 10-year follow-up of the Symax stem in THA: a Danish single-centre study

Cited by 5 publications

References 16 publications

Early stabilization of the uncemented Symax hip stem in a 2-year RSA study

Early stabilization of the uncemented Symax hip stem in a 2-year RSA study

Survival and reasons for revision of the uncemented Symax hip stem: A Dutch Arthroplasty Register study

Tapered stem geometry provides superior initial fixation stability to cylindrical stem geometry in the setting of severe bone loss: A finite element analysis

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