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Palacos compared to Palamed bone cement in total hip replacement: a randomized controlled trial

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ABSTRACT

Background and purpose: Stability and survival of cemented total hip prostheses is dependent on a multitude of factors, including the type of cement that is used. Bone cements vary in viscosity, from low to medium and high. There have been few clinical RSA studies comparing the performance of low- and high-viscosity bone cements. We compared the migration behavior of the Stanmore hip stem cemented using novel low-viscosity Palamed bone cement with that of the same stem cemented with conventional high-viscosity Palacos bone cement.

Patients and methods: We performed a randomized controlled study involving 39 patients (40 hips) undergoing primary total hip replacement for primary or secondary osteoarthritis. 22 patients (22 hips) were randomized to Palacos and 17 patients (18 hips) were randomized to Palamed. Migration was determined by RSA.

Results: None of these 40 hips had been revised at the 10-year follow-up mark. To our knowledge, the patients who died before they reached the 10-year endpoint still had the implant in situ. No statistically significant or clinically significant differences were found between the 2 groups for mean translations, rotations, and maximum total-point motion (MTPM).

Interpretation: We found similar migration of the Stanmore stem in the high-viscosity Palacos cement group and the low-viscosity Palamed cement group. We therefore expect that the risk of aseptic loosening with the new Palamed cement would be comparable to that with the conventional Palacos cement. The choice of which type of bone cement to use is therefore up to the surgeon’s preference.

No MeSH data available.


Mean endo-exo rotation (Ry in °) per group with 95% CI of the estimated marginal means per follow-up interval.
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Figure 0002: Mean endo-exo rotation (Ry in °) per group with 95% CI of the estimated marginal means per follow-up interval.

Mentions: Mean flexion-extension rotation (Rx) for the Palacos and Palamed groups was comparable over the different follow-up points (Figure 6, see Supplementary data). The mean rotation about the flexion-extension axis did not exceed 0.5°, which was below the upper limit of the 95% CI, indicating precision of RSA measurement in this study for rotations about that axis (Table 3). In both groups, the implant rotated internally and stabilized at about 1.0° of positive mean internal-external rotation (Ry) (Figure 7). Both the Palacos group and the Palamed group showed a small amount of lateral rotation over time. The mean abduction-adduction rotation (Rz) remained stable and did not exceed −0.5° in either group (Figure 8, see Supplementary data).


Palacos compared to Palamed bone cement in total hip replacement: a randomized controlled trial
Mean endo-exo rotation (Ry in °) per group with 95% CI of the estimated marginal means per follow-up interval.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016905&req=5

Figure 0002: Mean endo-exo rotation (Ry in °) per group with 95% CI of the estimated marginal means per follow-up interval.
Mentions: Mean flexion-extension rotation (Rx) for the Palacos and Palamed groups was comparable over the different follow-up points (Figure 6, see Supplementary data). The mean rotation about the flexion-extension axis did not exceed 0.5°, which was below the upper limit of the 95% CI, indicating precision of RSA measurement in this study for rotations about that axis (Table 3). In both groups, the implant rotated internally and stabilized at about 1.0° of positive mean internal-external rotation (Ry) (Figure 7). Both the Palacos group and the Palamed group showed a small amount of lateral rotation over time. The mean abduction-adduction rotation (Rz) remained stable and did not exceed −0.5° in either group (Figure 8, see Supplementary data).

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: Stability and survival of cemented total hip prostheses is dependent on a multitude of factors, including the type of cement that is used. Bone cements vary in viscosity, from low to medium and high. There have been few clinical RSA studies comparing the performance of low- and high-viscosity bone cements. We compared the migration behavior of the Stanmore hip stem cemented using novel low-viscosity Palamed bone cement with that of the same stem cemented with conventional high-viscosity Palacos bone cement.

Patients and methods: We performed a randomized controlled study involving 39 patients (40 hips) undergoing primary total hip replacement for primary or secondary osteoarthritis. 22 patients (22 hips) were randomized to Palacos and 17 patients (18 hips) were randomized to Palamed. Migration was determined by RSA.

Results: None of these 40 hips had been revised at the 10-year follow-up mark. To our knowledge, the patients who died before they reached the 10-year endpoint still had the implant in situ. No statistically significant or clinically significant differences were found between the 2 groups for mean translations, rotations, and maximum total-point motion (MTPM).

Interpretation: We found similar migration of the Stanmore stem in the high-viscosity Palacos cement group and the low-viscosity Palamed cement group. We therefore expect that the risk of aseptic loosening with the new Palamed cement would be comparable to that with the conventional Palacos cement. The choice of which type of bone cement to use is therefore up to the surgeon’s preference.

No MeSH data available.