Tapered uncemented HA-coated femoral stems: a radiological study

Bakkai, Ali; Ryan, Peter; Goga, IE

doi:10.17159/2309-8309/2017/v16n3a2

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…The details of these radiological features have been published previously. 33 We believe that both uncemented and cemented stems can be used with good outcomes, although the limitation of our relatively short follow-up needs to be kept in mind. The choice of implants should follow the standard selection criteria based mainly on the quality of bone of that patient.…”

Section: Discussionmentioning

confidence: 86%

The association between HIV infection and periprosthetic joint infection following total hip replacement in young adults

Ngwazi

Ryan

Goga³

et al. 2021

SA orthop. j.

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BACKGROUND: The HIV burden in South Africa is high. HIV-positive patients are at risk of developing avascular necrosis of the femoral head, necessitating total hip arthroplasty (THA) at a relatively young age. The primary aim of this study was to investigate the relationship between HIV infection and the risk of periprosthetic joint infection (PJI) in young adults following total hip replacement. Secondly, we aimed to evaluate the association of HIV infection with venous thromboembolic events, reoperation and revision surgery METHODS: We undertook a retrospective cohort study involving patients under the age of 55 years who underwent THA between 2009 and 2016 at a tertiary level arthroplasty unit. In total, 290 cases in 213 patients were analysed, with 77 patients requiring bilateral THA. The median age of patients was 43 years (interquartile range [IQR] 39-48, range 26-54 years). Sixty-two per cent of patients were HIV positive (n=180) with a median CD4 count of 520 cells/mm3 (IQR 423-659, range 238-1308 cells/mm3). Seventy-eight per cent (n=141) of the HIV-positive patients were on antiretroviral medication before surgery. Almost all cases performed in the HIV-positive group were for avascular necrosis (n=178, 99% RESULTS: At a median follow-up of four years (range 2-10) there were no revisions in either group. The incidence of PJI was 1.1% in the HIV-positive group vs 0.9% in the HIV-negative group. The odds ratio for the development of PJI in HIV-positive patients was 1.22 (95% CI 0.11 to 13.67, p=0.869). There was no association between the CD4 count of HIV-positive patients and the development of PJI (p=0.171). There was no difference in the rate of venous thromboembolic events between the HIV-positive and HIV-negative groups (4% vs 6%, p=0.340 CONCLUSION: We report on a cohort of young adult patients who underwent THA. Patients living with HIV infection were not found to be at increased risk for PJI following THA, when compared to HIVnegative patients. The premise that HIV infection increases the risk for PJI following THA remains to be substantiated. This study was underpowered in terms of the primary outcome measure and larger studies are required to verify these findings Level of evidence: Level 4 Keywords: total hip arthroplasty, HIV, AIDS, avascular necrosis, hip, periprosthetic joint infection

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Section: Discussionmentioning

confidence: 86%

The association between HIV infection and periprosthetic joint infection following total hip replacement in young adults

Ngwazi

Ryan

Goga³

et al. 2021

SA orthop. j.

View full text Add to dashboard Cite

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“…Subsidence was amongst the primary radiographic outcomes assessed and defined as an increase in prosthesis-greater trochanter distance of ≥ 2 mm [10]. Femoral component zones, as described by Gruen et al [13, 15], were further examined for signs of radiolucency and bony changes, including the formation of pedestals, spot welds, cortical hypertrophy, calcar rounding, calcar atrophy, and stress shielding [2]. A pedestal is defined as sclerosis at the distal tip of the femoral stem, which bridges the medullary canal.…”

Section: Methodsmentioning

confidence: 99%

The Actis and Corail Femoral Stems Provide for Similar Clinical and Radiographic Outcomes in Total Hip Arthroplasty

Kaszuba

Cipparrone

Gordon

2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: The introduction of new devices for total hip arthroplasty (THA) offers surgeons the ability to address deficits in the portfolio. However, once introduced, data regarding the performance of devices is not publicly available until their use is widespread. Purpose/Questions: The objective of this study was to compare the clinical and radiographic performance, including patient reported outcomes and radiographic evidence of osseointegration, subsidence, and stress shielding, of the newer Actis femoral component to the Corail stem (DePuy Synthes, Warsaw, IN, USA), which has an extensive clinical history. Methods: This short-term, retrospective cohort study was a single surgeon series of 330 anterior approach THAs, consisting of 165 cases using the Actis stem and 165 cases using the Corail stem. Both devices were cementless, titanium, tapered, hydroxyapatite-coated stems. They differed in geometry, neck choices, broach philosophy, and collar availability. Data was obtained for 1 year following THA. Functional outcomes were measured with the Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR.) survey. Complications were recorded from patient charts, and radiographic analysis was performed for signs of osseointegration, subsidence, and stress shielding. Results: The groups shared similar demographic characteristics except the Actis population was younger with fewer women. The complication rate did not significantly vary, and no patient required revision within the first year. Radiographically, one patient in each group demonstrated subsidence. No cases exhibited radiolucent lines, and the prevalence of stress shielding at 1 year was comparable. HOOS, JR. scores did not significantly vary at 8 weeks or 1 year. Conclusion: The Actis stem does not carry an increased risk of device-related complications compared with the Corail implant. Although aspects of bone remodeling differed between groups, Actis achieved radiographic signs of bone ingrowth at the 1-year mark and performed well clinically, with equivalent patient reported outcome scores to the Corail stem.

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“…Fully hydroxyapatite (HA)-coated stems are a type of cementless stem that have been widely used recently and are reported to have good long-term results [5]. HA-coated stems exhibit radiographic silence with less evidence of bone reactions, such as reactive lines (RLs) and cortical hypertrophy [6,7]. However, among 3 y postoperative cases of total hip arthroplasty (THA) using POLARSTEM (Smith & Nephew, Inc., Memphis, TN, USA), there were some cases with cancellous condensation, which were difficult to distinguish from RLs upon first glance on plain radiography.…”

Section: Introductionmentioning

confidence: 99%

New Evaluation Method for Bone Formation around a Fully Hydroxyapatite-Coated Stem Using Digital Tomosynthesis: A Retrospective Cross-Sectional Study

et al. 2021

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Digital tomosynthesis (DTS) is a new imaging technique derived from radiography, and its usefulness has been gradually reported in the field of orthopedic diagnosis in recent years. A fully hydroxyapatite (HA)-coated stem, which is used for total hip arthroplasty (THA), is a type of cementless stem that has been widely used recently and reported to have good results. However, stem loosening on plain radiographs is difficult to determine in some cases due to cancellous condensation around the stem. In this retrospective cross-sectional study, we compared the results of plain radiography versus DTS to evaluate the imaging findings after THA using a fully HA-coated stem. Twenty joints each in the 3 y and 1 y postoperative groups underwent plain radiography and DTS. On DTS, bone formation around the stem was confirmed in all cases; however, this formation was not reproducible on plain radiography, and there were cases in which the reaction could not be confirmed or cases with cancellous condensation resembling reactive lines. This reaction was not reproducible on plain radiographs, and in some cases, the reaction could not be confirmed, or there were cases with cancellous condensation that resembled reactive lines. Therefore, DTS was useful in the diagnosis of bone formation around the implant.

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Tapered uncemented HA-coated femoral stems: a radiological study

Cited by 3 publications

References 13 publications

The association between HIV infection and periprosthetic joint infection following total hip replacement in young adults

The association between HIV infection and periprosthetic joint infection following total hip replacement in young adults

The Actis and Corail Femoral Stems Provide for Similar Clinical and Radiographic Outcomes in Total Hip Arthroplasty

New Evaluation Method for Bone Formation around a Fully Hydroxyapatite-Coated Stem Using Digital Tomosynthesis: A Retrospective Cross-Sectional Study

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