Good Mid- to Long-Term THA Outcomes with a Modified Cementless Rectangular Biconical Stem Design

Iori, Stefano; Viganò, Roberto

doi:10.5301/hipint.5000353

Cited by 4 publications

(5 citation statements)

References 29 publications

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“…The results of a clinical evaluation of the Fitmore (Zimmer) stem showed a HHS of 99.0 with a mean follow-up of 2 years and 3 revisions in the same period of time [9]. The evaluation of the PPF (proximal press-fit) (Biomet) stem in a cohort of 142 patients was published in 2016 [10]. Iori and Vigano showed a survivorship of 99.1% after 10 years.…”

Section: Discussionmentioning

confidence: 99%

Results of 198 primary total hip arthroplasties using the Delta PF-FIT system with ceramic-on-ceramic articulating surfaces with average seven years follow up

Fulín

Pokorný

Heřt

et al. 2020

BMC Musculoskelet Disord

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Background The lifetime implants is a key parameter that the surgeon should take into account at the time of the primary total hip arthroplasty (THA). The aim of this study was a clinical and radiographical evaluation of the Delta PF-FIT (LimaCorporate, Italy) THA system with ceramic-on-ceramic articulations. We have not found a clinical or radiographical assessment of this implant in available published literature. Methods A total of 197 (F = 94, M = 103) primary THAs were evaluated in 163 patients with a mean follow-up of 7.7 years (range 5.1–11.2 years (SD ± 1.5)) Harris hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis index (WOMAC) were used for the clinical evaluation. The statistical evaluation was processed by standard statistical methods. The study was approved by Ethic Committee of the University Hospital Motol (Reference No. EK-73/19). Results The mean HHS score was found to be 97.59 points (61–100 range with a ± 5.13 SD, preoperative HSS was 51.21, range 28–73 with a ± 4,77 SD). 186 THAs were evaluated as excellent (90–100 points), 9 THAs rated as good (80–89 points), 1 THA was rated as fair (70–79) points and 1 THA rated as poor (less than 70 points). The mean WOMAC score was 97.38 points (65–100 range with a ± 5.18 SD, preoperative was 50,12, range 27–69 with a ± 4.85 SD). We documented an overall 99.49% Kaplan-Meier survival with a mean follow-up of 7.7 years with the FIT (LimaCorporate) stem revision and any component revision as the endpoint. With the Delta PF (LimaCorporate) cup revision as the endpoint, the survival was 100%. We have not found a previously published clinical or radiographical review of this THA system, the study shows a comparison with other THA implants. Conclusion Evaluation of the Delta-PF-FIT (LimaCorporate, Italy) THA system with the use of ceramic-on-ceramic BIOLOX®Delta articulation surfaces shows very good outcomes.

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Section: Discussionmentioning

confidence: 99%

Results of 198 primary total hip arthroplasties using the Delta PF-FIT system with ceramic-on-ceramic articulating surfaces with average seven years follow up

Fulín

Pokorný

Heřt

et al. 2020

BMC Musculoskelet Disord

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Section: Discussionmentioning

confidence: 99%

“…Clinical evaluation (using the HHS and VAS for pain) showed that patients experienced substantial improvements in health, although not as good as afforded by their primary operations, in agreement with the data of others who have reported clinical outcomes following placement of the tapered rectangular femoral stem. 34,35 Similarly to the Wagner stem, this stem shares with the SLR-Plus stem the principle of obtaining an immediate tight fit and mechanical stability through diaphyseal fixation of a long titanium alloy stem with a rough-blasted surface. In a series of 79 hips using Wagner stem, Gutierrez et al 7 reported subsidence in 16 at an average of 6 years after surgery, of which 1 exhibited subsidence >20 mm, and the stem subsidence is associated with excessive weight-bearing during the first 3 postoperative months.…”

Section: Discussionmentioning

confidence: 99%

Revision total hip arthroplasty in patients with femoral bone loss using tapered rectangular femoral stem: a minimum 10 years’ follow-up

et al. 2020

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Background: Revision total hip arthroplasty (THA) remains a significant challenge when there is severe femoral bone loss. The purpose of this study was to evaluate the clinical and radiographic outcomes of revision THA in patients with femoral bone loss treated with Zweymüller SLR-Plus stem. Methods: A retrospective review of 82 patients who underwent revision THA using tapered rectangular femoral stem between 1997 and 2007 was undertaken. Of the 82 patients, 9 patients were lost to follow-up and were excluded from the study. The most common reason for revision was aseptic loosening (92%), periprosthetic femur fracture (5%), and infection (3%). Bone loss was categorised preoperatively according to the Paprosky classification. The mean clinical follow-up was 14 years (range 10–19 years). Their mean age at the time of index surgery was 54.7 ± 15.3 (range 30–82) years. Results: The mean Harris Hip Score was significantly improved at final follow-up (68.1 ±10.3) compared with that before the revision surgery (30.4 ± 7.7) ( p < 0.0001). Of the 75 stems, 69 (92%) stems were radiographically stable at the last evaluation. Among the 69 stems, 64 hips (85%) had radiographic evidence of bone ingrowth and 5 (5%) had stable fibrous fixation of the stem. Among the 7 hips that were re-revised, 5 hips were re-revised for aseptic loosening, whereas 2 were re-revised for an infection. Kaplan-Meier survivorship analysis, with removal of the stem for any cause as the endpoint, revealed that the 15-year rate of survival of the components was 90% (95% CI, 0.83–0.97). Conclusion: Revision THA in patients with proximal femoral bone loss using Zweymüller SLR-Plus stem led to a high rate of osseointegration of the stem and good clinical results at long-term follow-up.

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“…Rectangular postoperatively by the baseline value. The values were expressed as area BMD in g/cm 2 .…”

Section: Characteristicmentioning

confidence: 99%

“…Total hip arthroplasty (THA) is an effective surgical procedure for treatment of end-stage hip osteoarthritis, osteonecrosis, and rheumatoid arthritis and can effectively improve function and reduce pain 1 . Cementless fixation is a standard fixation method and has been reported to have excellent midterm results 2,3 . Furthermore, cementless short-stem total hip arthroplasty can preserve femoral bone stock, address stress shielding effects, and provide a greater physiological load transfer than traditional THA, and its use has been on the rise in recent years 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Rectangular tapered short stem excellently preserves proximal bone mineral density preservation than tapered wedge short stem

ANJIKI,

HAYASHI,

FUJISHIRO

et al. 2023

Acta Orthop Belg

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Fitmore stem is a rectangular, tapered, short, cementless stem. A characteristic feature of this stem is that it provides rotational stability due to the high medullary occupancy achieved by its rectangular cross-section and thick antero- posterior width. We aimed to investigate the differences in periprosthetic bone remodelling between a rectangular- tapered short stem and a short tapered-wedge stem. Eighty patients who underwent primary total hip arthroplasty using a rectangular-tapered short stem (Fitmore) or a short tapered-wedge stem (Tri-Lock BPS) were enrolled in this study. Bone mineral densities (BMDs) in the seven Gruen zones were evaluated using dual-energy X-ray absorptiometry at baseline, and at 6 and 24 months postoperatively. Peri-prosthetic BMD and clinical factors were assessed and compared. In addition, correlations between periprosthetic BMD changes and stem anteversion error were analyzed using Pearson’s correlation coefficient in the two groups. A significantly better postoperative periprosthetic BMD change was found in zones 1 and 7 in the rectangular-tapered group. Additionally, no significant correlation was observed between stem anteversion error and periprosthetic BMD changes in the rectangular-tapered groups. However, in the tapered-wedge group, there were significant negative correlations between the stem anteversion error and BMD changes at 6 months and 24 months in zones 1 and 7. In the rectangular-tapered group, a significantly better postoperative periprosthetic BMD change was found particularly in the region proximal to the stem. Rectangular-tapered short stem can be more resistant to rotation due to higher medullary occupancy and may lead to better periprosthetic BMD than the tapered-wedge short stem, especially in the proximal region of the stem.

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Good Mid- to Long-Term THA Outcomes with a Modified Cementless Rectangular Biconical Stem Design

Abstract: The cementless proximal press-fit femoral stem was associated with good mid- to long-term survival and functional outcomes. The current design can be considered equivalent to the second- and third-generation Zweymüller stems.

Cited by 4 publications

References 29 publications

Results of 198 primary total hip arthroplasties using the Delta PF-FIT system with ceramic-on-ceramic articulating surfaces with average seven years follow up

Results of 198 primary total hip arthroplasties using the Delta PF-FIT system with ceramic-on-ceramic articulating surfaces with average seven years follow up

Revision total hip arthroplasty in patients with femoral bone loss using tapered rectangular femoral stem: a minimum 10 years’ follow-up

Rectangular tapered short stem excellently preserves proximal bone mineral density preservation than tapered wedge short stem

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