Limits...
High 10-year survival rate with an anatomic cementless stem (SPS).

Sariali E, Mouttet A, Mordasini P, Catonné Y - Clin. Orthop. Relat. Res. (2012)

Bottom Line: All stems appeared radiographically stable and one stem was graded nonintegrated but stable.Five patients had revision surgery: one on the femoral side (for posttraumatic fracture) and four on the acetabular side.Considering stem revision for aseptic loosening as the end point, survivorship was 100% (range, 95.4%-99.9%) at 10 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Hôpital Pitié Salpétrière, 47-83 Bd de l'Hôpital, 75013, Paris, France. hedisari@yahoo.fr

ABSTRACT

Background: Proximal cementless fixation using anatomic stems reportedly increases femoral fit and avoids stress-shielding. However, thigh pain was reported with the early stem designs. Therefore, a new anatomic cementless stem design was based on an average three-dimensional metaphyseal femoral shape. However, it is unclear whether this stem reduces the incidence of thigh pain.

Questions/purposes: We asked whether this stem design was associated with a low incidence of thigh pain and provided durable fixation and high function.

Methods: One hundred seventy-one patients (176 THAs) who had the anatomic proximal hydroxyapatite-coated stem implanted were reviewed. Eleven (6%) patients were lost to followup and 34 (20%) died without revision surgery. We used the Harris hip score (HHS) to assess pain and function. We evaluated femoral stem fixation and stability with the score of Engh et al. and also calculated a 10-year survival analysis. We assessed 126 patients (131 hips) at a mean followup of 10 years (range, 8-11 years)

Results: At last followup, two patients described slight thigh pain that did not limit their physical activities. All stems appeared radiographically stable and one stem was graded nonintegrated but stable. Five patients had revision surgery: one on the femoral side (for posttraumatic fracture) and four on the acetabular side. Considering stem revision for aseptic loosening as the end point, survivorship was 100% (range, 95.4%-99.9%) at 10 years.

Conclusion: This anatomic cementless design using only metaphyseal fixation with a wide mediolateral flare, a sagittal curvature, and torsion, allowed durable proximal stem stability and fixation.

Show MeSH

Related in: MedlinePlus

The implanted SPS stem had stable fixation at (A) 1, (B) 5, and (C) 10 years followup. (D) A lateral view obtained at the 10-year followup is shown.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3369068&req=5

Fig3: The implanted SPS stem had stable fixation at (A) 1, (B) 5, and (C) 10 years followup. (D) A lateral view obtained at the 10-year followup is shown.

Mentions: Patients underwent evaluation at 3 months postoperatively, and then yearly until the last followup. One orthopaedic surgeon not involved in the treatment (PM) performed the last radiographic reviews (Fig. 3). We performed clinical evaluation using the HHS [18]. We recorded the presence or absence of thigh pain at each visit.Fig. 3A–D


High 10-year survival rate with an anatomic cementless stem (SPS).

Sariali E, Mouttet A, Mordasini P, Catonné Y - Clin. Orthop. Relat. Res. (2012)

The implanted SPS stem had stable fixation at (A) 1, (B) 5, and (C) 10 years followup. (D) A lateral view obtained at the 10-year followup is shown.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369068&req=5

Fig3: The implanted SPS stem had stable fixation at (A) 1, (B) 5, and (C) 10 years followup. (D) A lateral view obtained at the 10-year followup is shown.
Mentions: Patients underwent evaluation at 3 months postoperatively, and then yearly until the last followup. One orthopaedic surgeon not involved in the treatment (PM) performed the last radiographic reviews (Fig. 3). We performed clinical evaluation using the HHS [18]. We recorded the presence or absence of thigh pain at each visit.Fig. 3A–D

Bottom Line: All stems appeared radiographically stable and one stem was graded nonintegrated but stable.Five patients had revision surgery: one on the femoral side (for posttraumatic fracture) and four on the acetabular side.Considering stem revision for aseptic loosening as the end point, survivorship was 100% (range, 95.4%-99.9%) at 10 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Hôpital Pitié Salpétrière, 47-83 Bd de l'Hôpital, 75013, Paris, France. hedisari@yahoo.fr

ABSTRACT

Background: Proximal cementless fixation using anatomic stems reportedly increases femoral fit and avoids stress-shielding. However, thigh pain was reported with the early stem designs. Therefore, a new anatomic cementless stem design was based on an average three-dimensional metaphyseal femoral shape. However, it is unclear whether this stem reduces the incidence of thigh pain.

Questions/purposes: We asked whether this stem design was associated with a low incidence of thigh pain and provided durable fixation and high function.

Methods: One hundred seventy-one patients (176 THAs) who had the anatomic proximal hydroxyapatite-coated stem implanted were reviewed. Eleven (6%) patients were lost to followup and 34 (20%) died without revision surgery. We used the Harris hip score (HHS) to assess pain and function. We evaluated femoral stem fixation and stability with the score of Engh et al. and also calculated a 10-year survival analysis. We assessed 126 patients (131 hips) at a mean followup of 10 years (range, 8-11 years)

Results: At last followup, two patients described slight thigh pain that did not limit their physical activities. All stems appeared radiographically stable and one stem was graded nonintegrated but stable. Five patients had revision surgery: one on the femoral side (for posttraumatic fracture) and four on the acetabular side. Considering stem revision for aseptic loosening as the end point, survivorship was 100% (range, 95.4%-99.9%) at 10 years.

Conclusion: This anatomic cementless design using only metaphyseal fixation with a wide mediolateral flare, a sagittal curvature, and torsion, allowed durable proximal stem stability and fixation.

Show MeSH
Related in: MedlinePlus