Clinical Outcome of Total Hip Arthroplasty Using the Normalized and Proportionalized Femoral Stem With a Minimum 20-Year Follow-Up

Sathappan, Sathappan S; Teicher, Matthew L.; Capeci, Craig; Yoon, Michelle; Wasserman, Bradley R.; Jaffe, William L.

doi:10.1016/j.arth.2006.04.004

Cited by 8 publications

(6 citation statements)

References 55 publications

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“…In the literature, a subsidence of less than 2–5 mm is accepted as normal [34–36]. Our subsidence of 1–2 mm could be interpreted as micromotion and as a sign of a stable implant [10, 12, 18, 23, 35–38]. Subsidence was significantly higher (≤ 2 mm) in the presence of CH than in its absence (≤ 1 mm).…”

Section: Discussionmentioning

confidence: 74%

“…In the retrospective short term (1–3 years), no clinical difference was found between patients with or without CH [10, 16]. The results may have started a competition between the new short stems and the conventional straight stems that have provided good results for three decades [18, 19]. This study aims to evaluate for the first time prospectively in a cohort with a follow-up of 5 years the clinical relevance of CH after implantation of the short curved Fitmore hip stem and to assess the effect of patient, surgical, and implant factors on the occurrence of CH.…”

Section: Introductionmentioning

confidence: 99%

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Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

et al. 2019

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Background An increased occurrence of cortical hypertrophy (CH) was observed 1–2 years after implanting short curved Fitmore hip stems. There are no published data about either the clinical relevance or the progression of CH over the long term. Methods Ninety-six primary total hip arthroplasties were performed between 2008 and 2010 using the Fitmore hip stem. Clinical and radiological parameters were recorded preoperatively and at 1, 2, 3, and 5 year follow-up. Results CH appeared mainly on antero-posterior radiographs in Gruen Zones 2, 3, 5, and 6. After 1 year, the diameter was 10 ± 2 mm and remained constant thereafter. The CH rate after 1 year was 69% and after 5 years 71%. Subsidence after 1 year was 1.6 ± 1.55 mm and 1.93 ± 1.72 mm after 5 years. Cortical thinning was 46% after 1 year and 56% after 5 years, mainly in Gruen Zones 7 and 8. In the first year radiolucencies were found in 51% in all Gruen Zones, and in 20% after 5 years. Patient, implant, and surgical factors did not correlate with radiological outcomes except that larger stems had more CH. After 5 years, the Harris Hip Score had improved from 59 to 94 and the Oxford Hip Score from 22 to 41. Radiographic parameters, notably CH, were not associated with clinical outcomes except that cortical thinning correlated with lower outcome scores. Conclusions CH correlated neither with clinical outcome nor with patient, surgical or implant factors, except for a positive correlation with stem size. The Fitmore hip stems settled within the first year to a stable fixation and then remained almost unchanged. However, cortical thinning is common in Gruen Zone 7 and 8 meaning that there is stress-shielding.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

et al. 2019

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“…With the introduction of linked semiconstrained TEA and non-linked resurfacing TEA, favourable mid-and long-term outcomes have been reported [1][2][3][4][5][6][7][8]. However, compared with total knee and total hip arthroplasties, survivorship remains lower and complication rates are higher [9,10]. With a loose-hinged articular surface, linked semi-constrained TEAs can compensate for soft-tissue imbalance and are thought to recreate physiological joint kinematics.…”

Section: Introductionmentioning

confidence: 99%

In vivo three-dimensional kinematics of total elbow arthroplasty using fluoroscopic imaging

Futai

Tomita

Yamazaki

et al. 2010

International Orthopaedics (SICOT)

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Higher complication rates and lower survivorship are still seen for total elbow arthroplasties compared to total knee and hip arthroplasties. This is partly due to polyethylene wear of the articular surface induced by excessive articular contact stress during elbow motion. The aim of this study was to dynamically evaluate in vivo three-dimensional elbow motion after total elbow arthroplasty. Twelve patients (15 elbows) who underwent operation with the Osaka University Model Total Elbow System were analysed using X-ray fluoroscopic imaging and a two-dimensional/three-dimensional registration technique, which could accurately estimate the three-dimensional spatial position of components. Valgus/varus angle and rotation between humeral and ulnar components showed wide variations among patients. Elbows with valgus angle and internal rotation >10 degrees could induce edge-loading of the articular surface. Component alignment, articular configuration, and soft-tissue balance can affect the kinematics of total elbow arthroplasty.

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“…A survival rate of the implant after THR of approximately 93% at 20 years has been documented [10,29]. However, leg length discrepancy following THR can be a significant problem and has been shown to contribute to patient dissatisfaction.…”

Section: Introductionmentioning

confidence: 99%

Does computer-assisted surgery benefit leg length restoration in total hip replacement? Navigation versus conventional freehand

Manzotti

Cerveri

Momi

et al. 2009

International Orthopaedics (SICOT)

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Leg length discrepancy following total hip replacement (THR) can contribute to poor hip function. Abnormal gait, pain, neurological disturbance and patient dissatisfaction have all been described as a result of leg length inequality after THR. The purpose of this study was to determine whether the use of computer navigation in THR can improve limb length restoration and early clinical outcomes. We performed a matched-pair study comparing 48 computer-assisted THR with 48 THRs performed using a traditional freehand alignment method. The same implant with a straight non-modular femoral stem was used in all cases. The navigation system used allowed the surgeon to monitor both acetabular cup placement and all the phases of femoral stem implantation including rasping. Patients were matched for age, sex, arthritis level, pre-operative diagnosis and pre-operative leg length discrepancy. At a minimum follow-up of six months, limb length discrepancy was measured using digital radiographs and a standardised protocol. The number of patients with a residual discrepancy of 10 mm or more and/or a postoperative over-lengthening were measured. The clinical outcome was evaluated using both the Harris Hip Score and the normalised Western Ontario and McMaster Universities (WOMAC) Arthritis Index. Restoration of limb length was significantly better in the computerassisted THR group. The number of patients with a residual limb length discrepancy greater than 10 mm and/or a post-operative over-lengthening was significantly lower. No significant difference in the Harris Hip Score or normalised WOMAC Arthritis Index was seen between the two groups. The surgical time was significantly longer in the computer-assisted THR group. No post-operative dislocations were seen.

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Clinical Outcome of Total Hip Arthroplasty Using the Normalized and Proportionalized Femoral Stem With a Minimum 20-Year Follow-Up

Cited by 8 publications

References 55 publications

Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

In vivo three-dimensional kinematics of total elbow arthroplasty using fluoroscopic imaging

Does computer-assisted surgery benefit leg length restoration in total hip replacement? Navigation versus conventional freehand

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