Cementless prosthesis of the hip joint with ?spongy metal? surface

Abstract

Our investigations in human specimens and animal experiments show that prostheses with a spongy metal surface can become fixed by bony ingrowth to varying degrees. After consistent clinical and radiological follow-up over 12-65 months (mean 34 months) in a prospective study of 100 consecutive patients in whom 106 cementless total hip replacements had been carried out, we were able to show that after 1 year 82% of patients were pain-free with the prosthesis fixed by bony ingrowth, 8% were pain-free with the prosthesis fixed by dense fibrous tissue and 10% were not pain-free, but did not want revision surgery. Thigh pain decreased steadily from 53% 3 months postoperatively to 6.6% 15 months after operation. We believe that, when the implantation technique is exact, a high percentage of cementless spongy metal prostheses are fixed by bony ingrowth, and that a cementless prosthesis should be implanted only in patients under 60 years of age without osteoporosis.

Metal-cancellous L�beck total hip arthroplasty in hemodialysis patients

“…Bone ingrowth into the metal-cancellous structure of the MCCL prosthesis has been demonstrated in animal experiments and by examination of specimens retrieved from patients [25,26]. The good radiological results in our series with no aseptic loosening suggest that bone ingrowth may prevent amyloid deposition at the implant-bone interface, which is thought to be one of the causes of aseptic loosening.…”

Systemic effectors of alveolar bone mass and implications in dental therapy

“…A 3-year prospective randomized trial that examined the prognostic value of osteoporosis in terms of implant failure indicated that 76% of failures occurred in osteoporotic patients (2). When cementless hip replacements were evaluated in 106 consecutive implants, the high success led to the reserved suggestion that a cementless prosthesis should be implanted only in patients without osteoporosis (35). Upon revision of 175 cementless porous coated prostheses, the observation of severe stress shielding (peri-implant bone loss of biomechanical etiology) was correlated with pre-operative osteoporosis (30).…”

The Metal-Cancellous Cementless Lübeck total hip arthroplasty

“…Bone ingrowth into the metal-cancellous structure has been demonstrated in animal experiments and in studies of specimens retrieved from patients. 13,14 Initial stability of the metal socket is achieved by two spikes wedged into the anterior and posterior parts of the acetabular rim, and a peg embedded into the ischium. The polyethylene liner is inserted during the operation, and has a 10° wedge-shaped overhang to increase superolateral coverage.…”

“…The Metal-Cancellous Cementless Lübeck (MCCL) prosthesis (S&G; ESKA, Lübeck, Germany) was developed with these aims and has been used in Europe and Japan, but only short-term results have been published. [12][13][14] We now report our intermediate-term clinical and radiological results.…”