The effect of partial or full weight bearing ambulation after cementless total hip arthroplasty

Woolson, Steven T.; Adler, Neil S.

doi:10.1054/arth.2002.34809

Cited by 44 publications

(19 citation statements)

References 13 publications

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“…Regardless of sex, the significant progressive subsidence demonstrated in this study does not concur with previous investigations that suggest immediate weight-bearing after cementless THA with either straight or tapered stems does not result in altered fixation of the femoral implant [2,3,11,17]. Our subsidence results were very similar to a previous study of a single-tapered, porous-coated, cementless stem (Taperloc®, Biomet, Warsaw, IN, USA) that began weight-bearing as tolerated on the day after surgery [11].…”

Section: Discussioncontrasting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

“…In addition, cementless components have demonstrated adequate fixation in the early postoperative period when combined with postoperative rehabilitation protocols involving the use of immediate weight-bearing [2,3,11,17]. Previous investigations have initiated weight-bearing immediately after THA with a straight femoral stem and reported no difference in clinical or radiographic outcomes [3,17]. Single-and double-tapered femoral designs have demonstrated increased subsidence in the first six weeks after surgery when combined with immediate weight-bearing, but have not resulted in significant progressive migration [2,11].…”

Section: Introductionmentioning

confidence: 99%

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Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty

Jacobs

Christensen

2008

International Orthopaedics (SICOT)

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The purpose of this study was to determine if subsidence of a tapered, proximally porous-and hydroxyapatite-coated femoral implant with immediate postoperative weight-bearing differed between men and women. Modified Harris Hip Pain and Function Scores were collected preoperatively, and six weeks and one year postoperatively. Femoral subsidence was determined at six weeks and one year after surgery. Men demonstrated significantly increased Harris Hip Function Scores at six weeks, with slightly inferior Harris Hip Pain Scores at one year. Regardless of sex, subsidence was greater at one year than at six weeks; however, men subsided significantly more at one year than women (1.7±2.0 mm vs 1.0±1.4 mm, p=0.03). While it appears that this stem provided excellent early fixation in women, it is unclear if the increased subsidence in men was more related to patient-related factors of age, weight and activity level or with specific implant characteristics.Résumé Le but de cette étude est de déterminer la migration et l'enfoncement d'une pièce fémorale lors d'une prothèse totale de hanche chez l'homme et chez la femme, après mise en charge immédiate, prothèse porous coated proximale recouverte d'hydroxyapatite. Matériel et méthode: le score de Harris douleur modifiée et le score fonctionnel ont été rapportés en pré-opératoire à 6 semaines et à un an post-opératoire. La migration a été également évaluée à 6 semaines et un an post-opératoire. Résultats: les hommes montrent un score fonctionnel de Harris significativement plus élevé à six semaines avec une diminution du score de douleur à un an. Si l'on prend en compte le sexe, la migration est plus importante à un an qu'à six semaines, cependant, chez l'homme, cette migration est plus importante à un an si on la compare à celle de la femme (1,7±2,0 mm vs. 1,0±1,4 mm, p=0,03). En conclusion, il apparaît que cette pièce fémorale donne d'excellents résultats concernant la fixation primaire chez la femme, chez l'homme la migration est un peu plus importante notamment si l'on prend également en compte les facteurs âge, poids, niveau d'activité.

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Section: Discussioncontrasting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty

Jacobs

Christensen

2008

International Orthopaedics (SICOT)

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“…The results are in agreement with published results of actual hip stems belonging to these groups. The AML, the Alloclassic and the ABG are all implants with excellent survival rates in short-term, medium-term and long-term [14][15][16][17][18][19][20][21][22][23][24][25][26] . The AML is one of the most widely used cementless stems with good clinical outcomes after hip arthroplasty [14] .…”

Section: Discussionmentioning

confidence: 99%

“…When solid initial fixation of the AML stem is achieved intraoperatively and radiographically, bone ingrowth reliably occurs whether or not the patient is allowed partial or full weight-bearing post surgery [18,19] . Dense cortical and cancellous bone ingrowth was found with strong attachment of the metal implant to the surrounding bone [20] .…”

Section: Discussionmentioning

confidence: 99%

Interface Micromotion of Cementless Hip Stems in Simulated Hip Arthroplasty

Kadir¹,

Kamsah²

2009

American J. of Applied Sciences

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Problem statement:The design of hip prostheses has evolved over time due to various complications found after hip replacement surgery. The currently commercially available cementless femoral stems can be categorized into one of three major types, straight cylindrical, tapered rectangular and anatomical. Each type proposes a unique concept to achieve primary stability-a major requirement for bone healing process. Virtual analyses have been made on individual implants, but comparison between the three major types is required to determine the strength and weaknesses of the design concepts. Approach: Three types of implants were modeled in three dimensions-the straight cylindrical, rectangular taper and anatomical. The size of the three implants was carefully designed to fit and fill the canal of a femur reconstructed from a computed tomography image dataset. Hip arthroplasty was simulated virtually by inserting the hip stem into the femoral canal. Finite element method was used in conjunction with a specialized sub-routine to measure micromotion at the boneimplant interface under loads simulating physiological walking and stair-climbing. Another subroutine was used to assign bone properties based on the grayscale values of the CT image. Results: All the three types of cementless hip stems were found to be stable under both walking and stair climbing activities. Large micromotion values concentrated around the proximal and distal part of the stems. Conclusion/Recommendations: The three major types of hip stems were compared in this study and all of them were found to be stable after simulated physiological activities.

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Effect of robotic milling on periprosthetic bone remodeling

Hananouchi

Sugano

Nishii

et al. 2007

Journal Orthopaedic Research

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ABSTRACT:The ROBODOC system has provided better fit and fill of the stem and less destruction of the bony architecture than with manual surgery. These benefits might affect femoral periprosthetic bone remodeling. We evaluated the effects of robotic milling in cementless total hip arthroplasty (THA) in a longitudinal 24-month follow-up study using dual energy X-ray absorptiometry (DEXA) and plain radiographs of 29 patients (31 hips) after ROBODOC THA and 24 patients (27 hips) after manual THA with the same stem design. To minimize the influence of other factors on bone remodeling, only female osteoarthritis patients, who had no drugs that might affect bone metabolism were enrolled. Significantly less bone loss occurred at the proximal periprosthetic areas in the ROBODOC group. In zone 1, the decrease was 15.5 versus 29.9% using conventional rasping; in zone 7, the loss was 17.0% with ROBODOC compared to 30.5% with conventional rasping (p < 0.05). On radiographs, endosteal spot welds in the proximal medial portion were more pronounced in the ROBODOC group (48 vs. 11% in the conventional group, p < 0.05). Our results suggest that robotic milling is effective in facilitating proximal load transfer around the femoral component and minimizing bone loss after cementless THA. ß

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The effect of partial or full weight bearing ambulation after cementless total hip arthroplasty

Cited by 44 publications

References 13 publications

Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty

Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty

Interface Micromotion of Cementless Hip Stems in Simulated Hip Arthroplasty

Effect of robotic milling on periprosthetic bone remodeling

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