Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: II. Clinical proof of concept—40 patients followed for 2 years

Carlsson, Lars; Albrektsson, Tomas; Albrektsson, Björn; Jacobsson, Catharina; Macdonald, Warren; Regnér, Lars; Weidenhielm, Lars

doi:10.1080/17453670610012610

Cited by 17 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The proximal migration observed at center 1 was similar to that reported with RSA by Carlsson et al who showed a median proximal translation at 3 years of 0.11 mm with the Gothenburg Osseointegrated Titanium cup with a roughblasted and etched surface [15,16]. Carlsson et al also showed 0.11 mm migration at 3 years for the Harris Galante II cup with a titanium fiber metal porous ingrowth surface in the same study [15,16]. Baad-Hansen et al found with RSA a mean proximal migration of 0.08 mm of a shell with a rough tantalum trabecular metal surface similar to PTC.…”

Section: Discussionsupporting

confidence: 87%

“…Our observations in conjunction with the findings from Thanner et al, suggest that the observed differences between the centers' cup migration in our study were more likely related to reaming techniques than screw-fixation. The proximal migration observed at center 1 was similar to that reported with RSA by Carlsson et al who showed a median proximal translation at 3 years of 0.11 mm with the Gothenburg Osseointegrated Titanium cup with a roughblasted and etched surface [15,16]. Carlsson et al also showed 0.11 mm migration at 3 years for the Harris Galante II cup with a titanium fiber metal porous ingrowth surface in the same study [15,16].…”

Section: Discussionsupporting

confidence: 71%

See 1 more Smart Citation

Three Year RSA Evaluation of Vitamin E Diffused Highly Cross-linked Polyethylene Liners and Cup Stability

Sillesen¹,

Greene²,

Nebergall³

et al. 2015

The Journal of Arthroplasty

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 71%

Three Year RSA Evaluation of Vitamin E Diffused Highly Cross-linked Polyethylene Liners and Cup Stability

Sillesen¹,

Greene²,

Nebergall³

et al. 2015

The Journal of Arthroplasty

View full text Add to dashboard Cite

“…Because of the marked differences in sample dimensions and duration of follow-up among all of the available clinical results, a corrective factor was used, based on cases revised per 100 observed component years, pointing out a benchmark of 90% of survivorship at 10-years of follow-up (or revision rate <1 per 100 component years), 2 consistent with the National Institute of Clinical Excellence (NICE) 7 and proposed by the Quality of Literature in Arthroplasty project (QoLA) supported by the European Federation of National Associations of Orthopaedics and Traumatology (Effort) and European Arthroplasty Registry (EAR). 8,9 Such unification of results reported for collum prostheses 2 has shown a high revision rate of 2 per 100 observed component years and an estimated survivorship at 10 years of more than 90%, except for the Gothenburg Osseointegrated Titanium (GOT) hip (Sweden), 10 but this was only on the basis of one study with 40 patients observed after 24 months of follow-up. The well-documented CUT stem (Eska, Luebeck, Germany) [11][12][13][14] showed a revision rate close to 1% per 100 observed component years, 11,14 but the overall rate reported in the literature for this particular stem missed the expected benchmark.…”

Section: Short Stem Resultsmentioning

confidence: 98%

Current Concepts, Classification, and Results in Short Stem Hip Arthroplasty

Falez¹,

Casella²,

Papalia³

2015

Orthopedics

102

View full text Add to dashboard Cite

Various short hip stems have been introduced with differing implant concepts of femoral fixation and implant length. There is a lack of proper classification for short hip stems, with a clear and accepted definition for implant length and extent of bone preservation in the metaphyseal and diaphyseal femur. This study analyzed the length of short hip stems. Stems were divided into collum, partial collum, and trochanter-sparing implants. An additional category was added, trochanter harming, which was defined as interruption of the circumferential integrity of the femoral neck. For all of the femoral components described, the designs were compared, excluding stems with insufficient clinical data. The 15 finally selected stems were classified as collum (1 stem), partial collum (7 stems), trochanter sparing (4 stems), and trochanter harming (3 stems). Mid-term results (>5 years of follow-up) were available for only 3 designs in the partial collum group. Taking into account the results of short-term studies (<5 years of follow-up), the femoral revision rate per 100 observed component years was <1 for most total hip arthroplasties. However, the studies varied greatly regarding level of significance, and short hip stems without published results are available commercially. Short hip stems cannot be circumscribed by a simple length limit. For some designs, clinical data collected from large patient cohorts showed a survivorship comparable to traditional stems. In cases that must be revised, this often can be performed with a conventional primary stem, fulfilling the promise to preserve bone for potential future revisions in younger patients.

show abstract

“…We do not know for certain why orthopedic implants commonly display mainly distance osteogenesis, but it may relate to a combination of preferred materials, the very blunt surgery performed and the early loading in comparison to the situation with oral implants. We know that orthopedic implants commonly display some micro movements in the initial phase after implantation, but that they later display secondary stabilization . Nevertheless, the distance osteogenesis may be another example of a bony demarcation of the implant and, with the new definition of osseointegration based on shielding off of a foreign material, a similar situation may apply for oral as well as orthopedic implants.…”

Section: Methodsmentioning

confidence: 99%

On inflammation‐immunological balance theory—A critical apprehension of disease concepts around implants: Mucositis and marginal bone loss may represent normal conditions and not necessarily a state of disease

Albrektsson

Jemt

Mölne

et al. 2018

Clin Implant Dent Rel Res

Self Cite

View full text Add to dashboard Cite

Background Oral implants have displayed clinical survival results at the 95%‐99% level for over 10 years of follow up. Nevertheless, some clinical researchers see implant disease as a most common phenomenon. Oral implants are regarded to display disease in the form of mucositis or peri‐implantitis. One purpose of the present article is to investigate whether a state of disease is necessarily occurring when implants display soft tissue inflammation or partially lose their bony attachment. Another purpose of this article is to analyze the mode of defense for implants that are placed in a bacteria rich environment and to analyze when an obtained steady state between tissue and the foreign materials is disturbed. Materials and Methods The present article is authored as a narrative review contribution. Results Evidence is presented that further documents the fact that implants are but foreign bodies that elicit a foreign body response when placed in bone tissue. The foreign body response is characterized by a bony demarcation of implants in combination with a chronic inflammation in soft tissues. Oral implants survive in the bacteria‐rich environments where they are placed due to a dual defense system in form of chronic inflammation coupled to immunological cellular actions. Clear evidence is presented that questions the automatic diagnostics of an oral implant disease based on the finding of so called mucositis that in many instances represents but a normal tissue response to foreign body implants instead of disease. Furthermore, neither is marginal bone loss around implants necessarily indicative of a disease; the challenge to the implant represented by bone resorption may be successfully counteracted by local defense mechanisms and a new tissue‐implant steady state may evolve. Similar reactions including chronic inflammation occur in the interface of orthopedic implants that display similarly good long‐term results as do oral implants, if mainly evaluated based on revision surgery in orthopedic cases. The most common mode of failure of orthopedic implants is aseptic loosening which has been found coupled to a reactivation of the inflammatory‐ immune system. Conclusions Implants survive in the body due to balanced defense reactions in form of chronic inflammation and activation of the innate immune system. Ten year results of oral and hip /knee implants are hence in the 90+ percentage region. Clinical problems may occur with bone resorption that in most cases is successfully counterbalanced by the defense/healing systems. However, in certain instances implant failure will ensue characterized by bacterial attacks and/or by reactivation of the immune system that now will act to remove the foreign bodies from the tissues.

show abstract

Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: II. Clinical proof of concept—40 patients followed for 2 years

Cited by 17 publications

References 22 publications

Three Year RSA Evaluation of Vitamin E Diffused Highly Cross-linked Polyethylene Liners and Cup Stability

Three Year RSA Evaluation of Vitamin E Diffused Highly Cross-linked Polyethylene Liners and Cup Stability

Current Concepts, Classification, and Results in Short Stem Hip Arthroplasty

On inflammation‐immunological balance theory—A critical apprehension of disease concepts around implants: Mucositis and marginal bone loss may represent normal conditions and not necessarily a state of disease

Contact Info

Product

Resources

About