Comparison of the uncemented Cone and the cemented Bimetric hip prosthesis in young patients with osteoarthritis: An RSA, clinical and radiographic study

Ström, Håkan; Kolstad, Kurt; Mallmin, Hans; Sahlstedt, Bo; Milbrink, Jan

doi:10.1080/17453670610045713

Cited by 26 publications

(20 citation statements)

References 27 publications

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“…Mean subsidence after 2 years was 0.13 mm for the CFP stem, which compares favorably with other uncemented stems. The Wagner-Cone prosthesis that was previously investigated at our institution showed a mean subsidence of 0.5 mm after 2 years (Ström et al 2006), and the CLS stem, also investigated at this institution, had subsided 1.42 mm after 2 years (Wolf et al 2010). Mean rotation of the CFP stem amounted to 0.01° of retroversion after 2 years, with a maximum amplitude of 1.4°, which is less than the amount of retroversion measured for the Wagner-Cone prosthesis (0.81° of retroversion after 2 years) and considerably less than the 2.39° of retroversion measured for the CLS stem after 2 years (Wolf et al 2010).…”

Section: Discussionmentioning

confidence: 81%

A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA

Lazarinis¹,

Mattsson²,

Milbrink³

et al. 2013

Acta Orthopaedica

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Background and purpose Short femoral stems have been introduced in total hip arthroplasty in order to save proximal bone stock. We hypothesized that a short stem preserves periprosthetic bone mineral density (BMD) and provides good primary stability.Methods We carried out a prospective cohort study of 30 patients receiving the collum femoris-preserving (CFP) stem. Preoperative total hip BMD and postoperative periprosthetic BMD in Gruen zones 1–7 were investigated by dual-energy x-ray absorptiometry (DXA), stem migration was analyzed by radiostereometric analysis (RSA), and the Harris hip score (HHS) was determined.Results 2 patients were excluded intraoperatively and 1 patient was revised due to a deep infection, leaving 27 patients for analysis. The mean HHS increased from 49 (24–79) preoperatively to 99 (92–100) after 2 years. DXA after 1 year showed substantial loss of BMD in Gruen zone 7 (–31%), zone 6 (–19%), and zone 2 (–13%, p < 0.001) compared to baseline BMD determined immediately postoperatively. The bone loss in these regions did not recover after 2 years, whereas the more moderate bone loss in Gruen zones 1, 3, and 5 partially recovered. There was a correlation between low preoperative total hip BMD and a higher amount of bone loss in Gruen zones 2, 6 and 7. RSA showed minor micromotion of the stem: mean subsidence was 0.13 (95% CI: –0.28 to 0.01) mm and mean rotation around the longitudinal axis was 0.01º (95% CI: –0.1 to 0.39) after 2 years.Interpretation We conclude that substantial loss in proximal periprosthetic BMD cannot be prevented by the use of a novel type of short, curved stem, and forces appear to be transmitted distally. However, the stems showed very small migration—a characteristic of stable uncemented implants.

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Section: Discussionmentioning

confidence: 81%

A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA

Lazarinis¹,

Mattsson²,

Milbrink³

et al. 2013

Acta Orthopaedica

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“…The qualitative analysis contains 5 articles that directly compare cemented and cementless femoral stems: 4 are of level I quality (RCTs) and one is of level III quality (retrospective controlled trials), as described in by the Oxford Centre for Evidence-Based Medicine [31], [32], [33], [34], [41], [42]. The reason that this is a qualitative analysis rather than a meta-analysis is due to 2 primary reasons: (1) lack of consistency when reporting outcomes and (2) absence of complete sets of data, for example, sample size, mean, and standard deviation.…”

Section: Resultsmentioning

confidence: 99%

“…[31], a level I study, was to compare femoral stem fixation in young patients of age <65 years. Two femoral stem designs were used: the Cone stem was used in all cementless cases (n = 22) and the Bimetric (Biomet, Warsaw, IN) grit-blasted femoral stem was used in all cemented cases (n = 23).…”

Section: Resultsmentioning

confidence: 99%

Still no single gold standard for using cementless femoral stems routinely in total hip arthroplasty

Moskal

Capps²,

Scanelli³

2016

Arthroplasty Today

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BackgroundThere is now a clear trend with increased usage of cementless femoral stems for all ages and most patients. As the number of total hip arthroplasties (THAs) performed annually continues to increase with expanding indications for THA and demands for improved quality of life, so will the prevalence of THA in the elderly and aging populations. This is worrisome as the risk of complications with cementless femoral stems increases in elderly patients and those with poor bone quality. The purpose of this study is to analyze the available data from comparative studies to determine whether cementless femoral stems are overused and whether cemented stems warrant increased consideration.MethodsUsing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searches were performed to find original studies comparing cementless and cemented femoral stems; large population registry studies and reports were also included.ResultsThis systematic review documents that older patients with cementless fixation increase the risk of revision, there is no clear fixation advantage in midaged patients, and younger patients fare better with cementless fixation. Complications after THA create burdens on the health care system and on patients.ConclusionsUsing evidence-based data should be better guidance in selecting the most reliable implants for THA. Although cementless femoral fixation for THA has evolved to the “new standard,” it has not been proven to be the “gold standard” for all patients.

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“…The position is not determined by the anatomical characteristics of the dysplastic femoral epiphysis [16], the circular section of the tapered stem, provided with 8 longitudinal sharp ribs, allows the surgeon to choose the degree of anteversion that he considers as better. Modular stems have been proposed as a solution to version, length and offset problems.…”

Section: Discussionmentioning

confidence: 99%

“…Stability of the stems could lead to the discussion of whether to use cemented stems. Ström [16] compared the use of uncemented cone prosthesis with the cemented Biemtric stem in young patients with osteoarthritis. They concluded that both were stable and had excellent clinical results after two years.…”

Section: Discussionmentioning

confidence: 99%

The Use of a Cementless Tapered Stem in Young Patients Affected of Secondary Hip Arthritis

Blanco¹

2014

J Arthritis

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Introduction: The Wagner cone stem was designed for uncemented hip arthroplasty in difficult proximal femoral conditions or femoral deformities. The most common indications for the use of this stem are secondary hip arthritis due to developmental hip dysplasia, septic arthritis or congenital malformations. We present a case series of patients that underwent hip arthroplasty with the use of a Wagner cone stem.

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Comparison of the uncemented Cone and the cemented Bimetric hip prosthesis in young patients with osteoarthritis: An RSA, clinical and radiographic study

Cited by 26 publications

References 27 publications

A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA

A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA

Still no single gold standard for using cementless femoral stems routinely in total hip arthroplasty

The Use of a Cementless Tapered Stem in Young Patients Affected of Secondary Hip Arthritis

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