Development and Verification of a Cementless Novel Tapered Wedge Stem for Total Hip Arthroplasty

Faizan, Ahmad; Wuestemann, Thies; Nevelos, Jim; Bastian, A; Collopy, Dermot

doi:10.1016/j.arth.2014.09.023

Cited by 37 publications

(28 citation statements)

References 12 publications

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“…The proximal stem represents the main engagement site of the parallel-sided femoral stem against the calcar bone [6]. Although the subjects with low cortical-bone thickness of the radius showed a high stem-to-canal fill ratio of the proximal stem, their stems tended to subside.…”

Section: Discussionmentioning

confidence: 99%

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Bone Mineral Density and Cortical-Bone Thickness of the Distal Radius Predict Femoral Stem Subsidence in Postmenopausal Women

Nazari-Farsani

Vuopio

Aro

2020

The Journal of Arthroplasty

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Background: The distal radius is an optional site for evaluation of bone quality in postmenopausal women before cementless total hip arthroplasty. We hypothesized that dual-energy X-ray absorptiometry (DXA) and pulse-echo ultrasonometry of the distal radius may help discriminate subjects at high risk of femoral stem subsidence. Methods: A prospective cohort of postmenopausal women with primary hip osteoarthritis underwent total hip arthroplasty with implantation of a parallel-sided femoral stem. Postoperative stem migration was measured using radiostereometric analysis. Preoperatively, subjects had multisite DXA measurement of bone mineral density (BMD) and pulse-echo ultrasonometry of the cortical-bone thickness. The diagnostic abilities of these methods to discriminate <2 mm and !2 mm femoral stem subsidence were tested. Results: The accuracy of the distal radius BMD and cortical-bone thickness of the distal radius were moderate (area under the curve, 0.737 and 0.726, respectively) in discriminating between <2 mm and !2 mm stem subsidence. Women with low cortical-bone thickness of the radius were more likely (odds ratio ¼ 6.7; P ¼ .002) to develop stem subsidence !2 mm. These subjects had lower total hip BMD (P ¼ .007) and reduced thickness of the medial cortex of the proximal femur (P ¼ .048) with lower middle (P < .001) and distal (P ¼ .004) stem-to-canal fill ratios. Conclusion: Femoral stem stability and resistance to subsidence are sensitive to adequate bone stock and unaltered anatomy. DXA and pulse-echo ultrasonometry of the distal radius may help discriminate postmenopausal women at high risk of stem subsidence.

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Section: Discussionmentioning

confidence: 99%

“…A parallel-sided femoral stem was designed to engage the metaphyseal cortical bone in the medial-lateral plane only [5,6]. The use of the stem requires adequate bone stock and unaltered femoral geometry [7], but no exact definitions have been determined for these requirements.…”

mentioning

confidence: 99%

Bone Mineral Density and Cortical-Bone Thickness of the Distal Radius Predict Femoral Stem Subsidence in Postmenopausal Women

Nazari-Farsani

Vuopio

Aro

2020

The Journal of Arthroplasty

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“…One femoral stem, curved in a coronal plane, was designed based on radiographic data from 497 patients (29). Another femoral stem, also curved in a coronal plane, was designed based on data from 556 CT scans (30,31). A femoral stem curved in a sagittal plane was used in humans (28).…”

Section: Discussionmentioning

confidence: 99%

Influence of chondrodystrophy and brachycephaly on geometry of the humerus in dogs

Smith

Marcellin‐Little

Harrysson

et al. 2016

Vet Comp Orthop Traumatol

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“…SOMA is a large, computed tomography-based, bone morphology database that contains 3D models that allows for anthropometric sizing to achieve the optimal depth and fixation of the tibial baseplate pegs. 26,[37][38][39] Prior to implantation, sclerotic areas of bone were drilled and autologous bone was used to fill bone defects as needed. After trials were performed, the final components were implanted, and the stability, range of motion, and patellar tracking were assessed.…”

Section: Methodsmentioning

confidence: 99%

Cementless Total Knee Arthroplasty in Patients Older Than 75 Years

et al. 2017

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Some surgeons have been hesitant to use cementless fixation for total knee arthroplasty (TKA) in elderly patients due to concerns regarding successful bone biological fixation. Therefore, this study evaluated: (1) implant survivorship, (2) functional outcomes, (3) radiographic outcomes, and (4) complications in patients over 75 years of age who underwent cementless total knee arthroplasty. A total of 134 patients (142 TKAs) older than 75 years at a single institution between June 2008 and June 2014 were retrospectively reviewed. Their mean follow-up was 4 years (range: 2-8 years). The cohort consisted of 91 women and 43 men who had a mean age of 80 years (range: 76 to 88 years). The preoperative diagnoses were osteoarthritis ( = 107 patients), rheumatoid arthritis ( = 21 patients), and osteonecrosis ( = 6 patients). Descriptive statistics were used to calculate the means and ranges and a Kaplan-Meier analysis was performed to determine the aseptic and all cause implant survivorship. Radiographic evaluation was performed using the new Knee Society Radiographic Evaluation and Scoring System. Functional outcomes at the final follow-up as well as all medical and surgical complications were recorded for each patient. The aseptic implant survivorship was 99.3% (95% CI: 7.9-8.1), and the all cause implant survivorship was 98.6% (95% CI: 7.9-8.1). There was one aseptic revision and one septic revision. At the latest follow-up the mean Knee Society pain score was 93 points (range, 80-100 points), and the mean Knee Society function score was 84 points (range, 70-90 points). On radiographic evaluation, there were no progressive radiolucencies, subsidence, and loosening of prostheses at the latest follow-up. The use of cementless TKA demonstrated excellent survivorship, mid-term clinical and functional outcomes, as well as no progressive radiolucencies or subsidence in patients older than 75 years. In addition, there was a low rate of surgical and medical complications. Therefore, cementless TKA may be a good option for patients older than 75 years.

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Development and Verification of a Cementless Novel Tapered Wedge Stem for Total Hip Arthroplasty

Cited by 37 publications

References 12 publications

Bone Mineral Density and Cortical-Bone Thickness of the Distal Radius Predict Femoral Stem Subsidence in Postmenopausal Women

Bone Mineral Density and Cortical-Bone Thickness of the Distal Radius Predict Femoral Stem Subsidence in Postmenopausal Women

Influence of chondrodystrophy and brachycephaly on geometry of the humerus in dogs

Cementless Total Knee Arthroplasty in Patients Older Than 75 Years

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