Cementless total hip arthroplasty in patients older than 80 years of age

Abstract

e reviewed 80 patients (87 hips) who were older than 80 years of age at the time of cementless total hip arthroplasty. An Alloclassic SL stem had been implanted in all patients. A variety of cementless acetabular components was used. After a mean followup of 69.3 months (39.2 to 94.1) 48 hips in 43 patients were analysed clinically and radiologically. One patient had sustained a traumatic periprosthetic fracture of the femur with subsequent exchange of the stem 73 months after operation. Thirty-two patients (34 hips) had died and five patients (five hips) were unavailable for followup because of health reasons (four patients) or lack of co-operation (one patient). If the endpoint is defined as removal of the prosthesis because of aseptic loosening, the survival rate was 100% for the cup and stem after 78 months. The mean Harris hip score was 81.9 points. Radiolucent lines and osteolysis were seldom found.

Behaviour of the ultra-short anatomic cementless femoral stem in young and elderly patients

“…In our study, the fixation was successful in both groups and stability of the femoral component had not deteriorated at mid-term followup. Thus the performance of the cementless ultra-short, metaphyseal-fitting anatomic femoral component in these consecutive series of young and elderly patients was comparable to that of other conventional cementless femoral components [7,10,27,[33][34][35]. Santori et al [32] observed mild stress-shielding with a rounding off of the calcar region in seventy of 131 femora after using their custom-made ultra-short femoral component.…”

“…Although the results of modern cemented or cementless total hip arthroplasty (THA) are generally good [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], thigh pain, stress shielding and periprosthetic fracture are still potential problems [2,[6][7][8][9]. In an effort to reduce the periprosthetic fracture, thigh pain, and stress shielding, an ultra-short, anatomic metaphyseal-fitting cementless femoral component was developed.…”

Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

“…We showed that it is possible to obtain optimal fixation of a short metaphyseal-fitting anatomic cementless stem without diaphyseal fixation in young patients and that there was no thigh pain and little stress shielding with this approach. On the basis of hip scores, this implant seems comparable to others [11,[35][36][37][38][41][42][43] but without a controlled trial, there is no way to know for sure [1,2,7,18,19,[21][22][23][24][25][26][27][28]. A potential concern with the use of short, metaphyseal-fitting anatomic cementless femoral components is whether stable fixation can be obtained without diaphyseal fixation.…”

Cemented calcar replacement versus cementless hemiarthroplasty for unstable intertrochanteric femur fractures in elderly.

“…Two recent studies reported an implant survival rate of about 100% after total hip arthroplasty after more than 5 years follow-up in patients older than 75 years of age. [19,20] No implant failure was reported in the studies, which evaluated cementless hemiarthroplasty for unstable intertrochanteric fractures in elderly patients. [2,4,5,10,11] Even in cementless modular hip arthroplasty after failed trochanteric fracture fixation, none of the patients required reoperation due to the loosening of femoral prosthesis.…”