Movement pattern of the Exeter femoral stemA radiostereometric analysis of 22 primary hip arthroplasties followed for 5 years

Stefánsdóttir, Anna; Franzén, Herbert; Johnsson, Ragnar; Ornstein, Ewald; Sundberg, Martin

doi:10.1080/00016470410001169-1

Cited by 55 publications

(41 citation statements)

References 13 publications

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“…The range of total [42] and is slightly lower than the values reported by Ornstein et al [29] ( Table 3). The pattern of stem fixation achieved is also comparable to that reported for primary THA using the same stem design [1,37] (Table 3). Most of the subsidence occurred at the prosthesis-cement interface and is comparable to the 1 to 2 mm of self-limiting subsidence reported for primary stems which have 100% survival with revision of the stem for aseptic loosening at ten years' follow-up (Table 3) [1,44].…”

Section: Discussionsupporting

confidence: 70%

Reduced Femoral Component Subsidence with Improved Impaction Grafting at Revision Hip Arthroplasty

Howie

Callary

McGee

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Despite stem subsidence being a major complication of femoral impaction bone grafting in cemented revision hip arthroplasty, few studies have distinguished subsidence at the prosthesis-cement interface from that at the cement-bone interface. It is unknown how technique developments intended to improve the procedure influence stability of the stem. Questions/purposes We used a sensitive technique to measure subsidence of a cemented polished collarless double-taper stem at each interface after femoral impaction grafting and compared subsidence, radiographic loosening, complications, and reoperations over three series of hips defined by technique developments. Patients and Methods Three series were defined: Series 1 (n = 23, irradiated allograft), Series 2 (n = 12, doublewashed, size-profiled graft, nonirradiated bone, long stems as required), and Series 3 (n = 21, modular tamps). Stem subsidence was analyzed with Ein Bild Röntgen Analyse software. Radiographic loosening, complications, and reoperations were also determined. Results The median subsidence at 12 months for Series 1, 2, and 3 were 2.1, 0.5, and 0.7 mm at the prosthesis-cement interface and 1.3, 0

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Section: Discussionsupporting

confidence: 70%

Reduced Femoral Component Subsidence with Improved Impaction Grafting at Revision Hip Arthroplasty

Howie

Callary

McGee

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…It is accurate to ±47 µm, with a precision of 30 µm when monitoring femoral stem distal migration [12]. The RSA technique has been used to evaluate mid to long-term outcome, compare cementless and cemented stems, or, more commonly, assess the wear of the acetabular component of hip prostheses [13][14][15]. However, there are comparatively few studies evaluating early migration characteristics of cementless stems using this technique.…”

Section: Introductionmentioning

confidence: 99%

Early migration characteristics of a hydroxyapatite-coated femoral stem: an RSA study

Campbell

Mercer

Nilsson

et al. 2009

International Orthopaedics (SICOT)

102

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Measurement of early stem subsidence can be used to predict the likelihood of long-term femoral component loosening and clinical failure. Data that examines the early migration pattern of clinically proven stems will provide clinicians with useful baseline data with which to compare new stem designs. This study was performed to evaluate the early migration pattern of a hydroxyapatitecoated press-fit femoral component that has been in use for over ten years. We enrolled 30 patients who underwent THA for osteoarthritis. The median age was 70 years (range, 55-80 years). Patients were clinically assessed using the Harris hip score. Radiostereometric analysis was used to evaluate stem migration at three to four days, six months, one year and two years. We observed a mean subsidence of 0.73 mm at six months, 0.62 mm at one year and 0.58 mm at two years and a mean retroversion of 1.82°at six months, 1.90°at one year and 1.59°at two years. This data suggests that subsidence is confined to the first six months after which there was no further subsidence. The results from this study can be compared with those from novel cementless stem designs to help predict the long-term outcome one may expect from new cementless stem designs.

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“…Several RSA studies conclude that the migration of a cemented femoral stem mainly occurs at the implant–cement interface, not between the cement mantle and surrounding bone [15–17]. Tantalum markers that are mixed into the cement are difficult to scatter and also difficult to visualize on radiographs [17].…”

Section: Methodsmentioning

confidence: 99%

The migration pattern of the Charnley femoral stem: a five-year follow-up RSA study in a well-functioning patient group

Haugan

Husby

Klaksvik

et al. 2012

J Orthopaed Traumatol

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BackgroundImplant stability is considered vital to long-time implant survival in total hip arthroplasty (THA), since loose implants are reported to be a major cause of hip revision. There is an association between early implant micromotion and increased risk of revision. More implant-specific data are needed to establish acceptable levels of early implant movement.Materials and methodsThirty-five patients (36 hips) undergoing Charnley THA were followed with repeated clinical, radiographic, and radiostereometric analysis (RSA) over 5 years. Twenty-three patients attended 5 years postoperatively.ResultsThe patient group was well functioning based on the radiological and clinical evaluations. The stems constantly moved up to 5 years postoperatively, with subsidence, retroversion, and varus tilt, based on the RSA.ConclusionContinuous movement of the Charnley stem was observed up to 5 years postoperatively in a well-functioning patient group. The migration data presented herein could be useful when defining acceptable migration limits for certain types of cemented femoral stems.

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Movement pattern of the Exeter femoral stemA radiostereometric analysis of 22 primary hip arthroplasties followed for 5 years

Abstract: We found a greater distal migration of the Exeter stem for longer periods of time than seen with other types of cemented implants.

Cited by 55 publications

References 13 publications

Reduced Femoral Component Subsidence with Improved Impaction Grafting at Revision Hip Arthroplasty

Reduced Femoral Component Subsidence with Improved Impaction Grafting at Revision Hip Arthroplasty

Early migration characteristics of a hydroxyapatite-coated femoral stem: an RSA study

The migration pattern of the Charnley femoral stem: a five-year follow-up RSA study in a well-functioning patient group

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