Low Short-Stem Revision Rates: 1-11 Year Results From 1888 Total Hip Arthroplasties

Schnurr, Christoph; Schellen, Bernd; Dargel, Jens; Beckmann, Johannes; Eysel, Peer; Steffen, R.

doi:10.1016/j.arth.2016.08.009

Cited by 43 publications

(55 citation statements)

References 23 publications

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“…The mid-to long-term clinical results for some modular dual taper stem designs are comparable to the implant survivorship of mono-bloc cementless stem designs [7,9,[11][12][13][14][15]. Examining the effectiveness of neck modularity in THA considering sex differences in hip morphology, Traina et al [7] retrospectively reviewed the clinical results of 2131 modular stems implanted in 1051 men and 1080 women.…”

Section: Introductionmentioning

confidence: 99%

How to Proceed with Asymptomatic Modular Dual Taper Hip Stems in the Case of Acetabular Revision

Grupp

Baxmann²,

Jansson

et al. 2020

Materials

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How to proceed with a clinically asymptomatic modular Metha® Ti alloy stem with dual taper CoCr neck adapter in case of acetabular revision? To systematically answer this question the status of research and appropriate diagnostic methods in context to clinically symptomatic and asymptomatic dual taper stem-neck couplings has been evaluated based on a systematic literature review. A retrieval analysis of thirteen Metha® modular dual taper CoCr/Ti alloy hip stems has been performed and a rational decision making model as basis for a clinical recommendation was developed. From our observations we propose that in cases of acetabular revision, that for patients with a serum cobalt level of > 4 µg/L and a Co/Cr ratio > 3.6, the revision of the modular dual taper stem may be considered. Prior to acetabular revision surgery a systematic diagnostic evaluation should be executed, using specific tests such as serum metal (Co, Cr) ion analysis, plain antero-posterior and lateral radiographs and cross-sectional imaging modalities (Metal Artefact Reduction Sequence Magnetic Resonance Imaging). For an asymptomatic Metha® dual taper Ti alloy/CoCr stem-neck coupling at the stage of acetabular revision careful clinical decision making according to the proposed model should be followed and overreliance on any single examination should be avoided, considering the complete individual differential diagnosis and patient situation.

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Section: Introductionmentioning

confidence: 99%

How to Proceed with Asymptomatic Modular Dual Taper Hip Stems in the Case of Acetabular Revision

Grupp

Baxmann²,

Jansson

et al. 2020

Materials

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“…The Metha prosthesis (Aesculap), which was originally similar in design, attempted to offset the disadvantages of the Mayo prosthesis by means of modularity [18]. However, a material failure with a subsequent cone breakage occurred in the region of the adapter in 9.4 % of cases for the titanium cones and in 4.6 % of cases for the cobalt-chromium cones [17]. Monoblock prostheses were therefore developed in turn; these also take account of the requirement for a reduced CCD angle.…”

Section: Varus Valgusmentioning

confidence: 99%

A Differentiated View on Short Stemmed Hip Arthroplasty – What are the Differences in Fixation and Biomechanics?

Jerosch

Engelhardt

2019

Z Orthop Unfall

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The present paper gives an overview of the different types of short stem total hip replacements. There is a pronounced inhomogeneity of the nomenclature in clinical practice as well as in regard to the scientific literature. Examples include neck preserving implants, meta-, epi- or metadiaphyseal fixed implants, microimplants, ultrashort implants, partial neck preserving implants, trochanteric sparing implants, implants with extra- and/or intramedullar fixation, implants without primary fixation, etc. Biomechanically, the short stems vary from very short, completely neck retaining versions up to implants which are just a shorter version of a standard implant. A frequently cited classification recommends the osteotomy level as a discriminating factor. This classification categorizes into a neck preserving, partial neck preserving and neck resecting short stems.

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“…Es gibt viele unterschiedliche Hüfttotalendoprothesen im Hinblick auf das Design [1, 5 -7]. Verschiedene Fixationstechniken sind dabei abhängig von der Resektionshöhe, diese wiederum ist verantwortlich für den Knochenerhalt respektive den Knochenverlust [17]. In der rezenten Vergangenheit hat ein Philosophiewandel stattgefunden, es werden zunehmend kürzere knochenerhaltende Designs verwendet.…”

Section: Diskussionunclassified

Finite Element Analysis and Biomechanical Testing of the New MiniMIS Short Stem

Trieb

Huber²,

Sonntag

et al. 2019

Z Orthop Unfall

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Introduction In hip arthroplasty a trend towards short stem prostheses is observed. The aim of this study is to investigate the finite element analysis and biomechanical fatigue performance of a new short stem prosthesis. Methods A finite element analysis was used to simulate the stresses during neck and stem loading according to the ISO standards. Numerical analysis with applied forces of up to 6 kN were performed in the vertical direction on a femoral neck-preserving stem (MiniMIS). During experimental testing, 10 million cycles with a maximum load of 5.34 kN using the worst case of a XL ceramic head (36 mm) were applied. This was followed by a Locati test, where the load was increased until failure of the stem. Results For all stems, stress values below the limits according to the ISO 5832-3 standard (yield strength of 800 N/mm2) were calculated by the finite element analysis. In the biomechanical tests, the total number of 10 million cycles with a maximum load of 5.34 kN was reached in all cases without any visible signs of implant damage. The estimated load to failure after stem testing was 2.16 kN (required by ISO 7206-4: 1.2 kN) and after neck testing > 9.35 kN (required by ISO 7206-6: 5.4 kN). Summary The presented finite element calculation and subsequent biomechanical testing show that the design of this stem meets the essential mechanical requirements given by the ISO and a material failure is not expected in all variants tested under the applied boundary conditions.

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Low Short-Stem Revision Rates: 1-11 Year Results From 1888 Total Hip Arthroplasties

Cited by 43 publications

References 23 publications

How to Proceed with Asymptomatic Modular Dual Taper Hip Stems in the Case of Acetabular Revision

How to Proceed with Asymptomatic Modular Dual Taper Hip Stems in the Case of Acetabular Revision

A Differentiated View on Short Stemmed Hip Arthroplasty – What are the Differences in Fixation and Biomechanics?

Finite Element Analysis and Biomechanical Testing of the New MiniMIS Short Stem

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