Early perioperative complication rates and subsidence with the Tribute® short cementless, tapered stem in primary total hip arthroplasty

Attenello, John; Chan, Sean; Naito, Kelvin; Saruwatari, Michele; Saito, Sean; Andrews, Samantha; Nakasone, Cass K.

doi:10.1016/j.jor.2019.01.002

Cited by 7 publications

(4 citation statements)

References 40 publications

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“…Finally, short uncemented stems are associated with significantly reduced primary stability (Ong et al, 2009), and although our results are encouraging, they cannot provide a definite answer as to the primary stability of shortened stems. A recent study evaluating early outcomes of THA using a comparable shortened stem to the one evaluated in this study, but collarless, found encouragingly low rates of stem subsidence, which exhibited no progression after 6 months (Attenello et al, 2019). It is nevertheless important to note that CFR alone cannot predict stem subsidence, good osseointegration or load transmission, so that further investigation remains necessary to evaluate the success of shortened stems.…”

Section: Discussionmentioning

confidence: 61%

A shortened uncemented stem offers comparable positioning and increased metaphyseal fill compared to a standard uncemented stem

Jacquel

Viguelloux²,

Valluy

et al. 2019

J EXP ORTOP

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Background Shortened stems are increasingly used in uncemented total hip arthroplasty (THA) as they represent a compromise between the metaphyseal anchorage of short stems and the facilitated axial alignment of standard stems. The purpose of this study was to compare the metaphyseal canal-fill ratio (CFR) and axial alignment of a shortened double-tapered stem with those of a standard stem. The hypothesis was that the shortened stem would achieve greater metaphyseal fill and comparable axial alignment. Methods The authors reviewed routine follow-up anteroposterior radiographs taken 2 months after THA to evaluate metaphyseal fill and axial alignment of a shortened stem ( n = 96) and a standard stem ( n = 101). The CFR was calculated at the level of the tip and superior margin of the lesser trochanter. Stem alignment was defined as the angle between the stem axis and the proximal anatomic femoral axis. Stems were classified as being in varus or valgus alignment if they deviated by more than 3° from the anatomic axis of the femur. Results Hips implanted with shortened and standard stems had comparable demographics and axial alignment (1.1° ± 1.7° vs 0.8° ± 1.2°; p = 0.331). However, varus alignment was observed in 5% of shortened stems compared to only 1% of standard stems, though this difference was not significant ( p = 0.111). The femoral CFR was greater using shortened stems than using standard stems, both at the level of the tip of the lesser trochanter (0.91 ± 0.05 vs 0.85 ± 0.08; p < 0.001) and at its superior margin (0.76 ± 0.06 vs 0.72 ± 0.07; p < 0.001). Conclusions Compared to the standard stem, the shortened stem had increased metaphyseal filling and equivalent alignment. These findings suggest that shortened stems could provide adequate metaphyseal fixation and correct alignment. Further studies remain necessary to evaluate how shortened stems perform in terms of osseointegration, clinical outcomes and survival.

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Section: Discussionmentioning

confidence: 61%

A shortened uncemented stem offers comparable positioning and increased metaphyseal fill compared to a standard uncemented stem

Jacquel

Viguelloux²,

Valluy

et al. 2019

J EXP ORTOP

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“…Our findings are comparable with the 2018 Australian implant registry data showing a 3.5% revision rate at five years for the AMIStem-H® combined with the same cup [ 9 ], but are higher than those reported for other short stems implanted through the DAA. In a retrospective review of 247 consecutive THAs with the Tribute® short stem, Attenello et al [ 10 ] reported a femoral stem subsidence of more than 5 mm in four hips, and none required revision surgery at 27-month follow-up. In a retrospective review of 899 consecutive patients followed up to 24 months, Cidambi et al [ 11 ] found a 1.3% revision rate for femoral aseptic loosening of a short, mediolaterally tapered stem.…”

Section: Discussionmentioning

confidence: 99%

Short stem total hip arthroplasty with the direct anterior approach demonstrates suboptimal fixation

Garavaglia

Gonzalez

Baréa

et al. 2021

International Orthopaedics (SICOT)

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Purpose Short stems use has increased substantially despite variable results reported in the literature. The purpose of this study was to report the rate of complications using a short stem implanted through the direct anterior approach (DAA), and to evaluate mid-term clinical and radiological results focusing on femoral stem fixation. Methods Between April 2009 and November 2014, 698 elective total hip arthroplasties (THAs) were performed using a fully hydroxyapatite-coated short stem (AMIStem-H®). The mean age was 65.7 years (SD 12.6). Patients were invited for clinical and radiological evaluation, and to complete patient-reported outcomes questionnaires at two and five years after surgery. The mean follow-up was 6.2 years (range 2–9.73 years). Results During the study period, 59 (8.5%) patients died and 24 (3.4%) were lost to follow-up. There were six (0.9%) dislocations and 12 (1.7%) fractures, seven occurred intra-operatively. Twenty-nine (4.2%) THAs required revision surgery. Eleven THAs were revised for aseptic loosening of the stem at a mean 4.9 years (1.2–7.3 years). Five years after surgery, radiographs of 324 THAs (324/425 eligible = 76.2%) were available. Stem subsidence ≥ 2 mm was present in 42 cases (12.9%), proximal radiolucencies in 101 hips (31.5%), cortical thickening in 52 (16.0%), and a pedestal in 219 (67.6%). An Engh score between − 10 and 0 was associated with lower HHS pain subscore (p = 0.005), a higher risk of stem revision for aseptic loosening (18.8% vs. 2.7%; p = 0.008), and was more frequent in younger patients with ASA score 1. Conclusion Patients presenting radiological alterations at five years had an increased risk of revision for aseptic stem loosening and also inferior clinical results. Our study warrants further continued scrutiny of mid- and long-term survivorship of the AMIStem-H®, with radiological results at five years indicating suboptimal fixation of the stem in younger and active patients.

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“…Accordingly, some orthopedic surgeons used shorter femoral stems to reduce the risk of periprosthetic fractures and muscle injuries [8]. Short stems have been frequently used in THA [9], as they have a small surgical incision, thereby preserving more bone tissues and providing more favorable surgical conditions [10,11]. Previous trials revealed a short-term survival of 94-100% and an incidence of thigh pain of 4%-18% in patients receiving THA with short stems [8,9,[12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Tri-Lock Bone Preservation Stem Versus Conventional Corail Stem in Primary Total Hip Arthroplasty via Direct Anterior Approach: A Short-Term, Retrospective, Comparative Study

et al. 2023

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Background:The present study was performed to evaluate the clinical efficacy of Tri-Lock bone preservation stems vs conventional Corail stems in primary total hip arthroplasty via direct anterior approach. Material/Methods:In this retrospective analysis, patients receiving THA via DAA in a single-center hospital from January 2019 to March 2020 were assessed for eligibility and assigned to either a Tri-Lock BPS group or a Corail group based on the use of prostheses. Outcome measures for the efficiency evaluation of the 2 prostheses included perioperative outcomes, imaging results, Harris Hip Score, Western Ontario and McMaster University Osteoarthritis Index, and visual analog scale scores at 3, 6, 12, and 24 months postoperatively. Results: A total of 204 patients were included, including 98 patients (98 hips) in the Tri-Lock BPS group and 106 patients (106 hips) in the Corail group. Patients receiving Tri-Lock BPS exhibited better pain relief than those with Coral stems. Tri-Lock BPS had a higher safety profile vs Corail stems by significantly reducing the risk of complications (P=0.004). A markedly increased HHS score (84.42±16.27 vs 78.61±12.78, P=0.002) and a lower WOMAC score (25.08±15.39 vs 32.14±11.56, P=0.001) at 3 months postoperatively were observed in patients with Tri-Lock BPS vs those with Corail stems, indicating better restoration of hip function using Tri-Lock BPS. Conclusions:During total hip arthroplasty via DAA, Tri-Lock BPS causes a smaller surgical wound, reduces the operative time and intraoperative bleeding, and produces less soft-tissue damage vs Corail stems, providing great benefits in femoral prosthesis placement.

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Early perioperative complication rates and subsidence with the Tribute® short cementless, tapered stem in primary total hip arthroplasty

Cited by 7 publications

References 40 publications

A shortened uncemented stem offers comparable positioning and increased metaphyseal fill compared to a standard uncemented stem

A shortened uncemented stem offers comparable positioning and increased metaphyseal fill compared to a standard uncemented stem

Short stem total hip arthroplasty with the direct anterior approach demonstrates suboptimal fixation

Tri-Lock Bone Preservation Stem Versus Conventional Corail Stem in Primary Total Hip Arthroplasty via Direct Anterior Approach: A Short-Term, Retrospective, Comparative Study

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