Uncemented total hip arthroplasty in the elderly

Konstantoulakis, Ch.; Anastopoulos, G.; Papaeliou, A.; Tsoutsanis, Ath; Asimakopoulos, A.

doi:10.1007/s002640050385

Cited by 27 publications

(11 citation statements)

References 13 publications

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“…Our study had 27% and 29% complication rate in the cemented and the non-cemented groups, respectively, which is similar to other reports that show similar complications between the two groups [22][23][24][25]. Other studies of elder patients undergoing THA have shown good to excellent clinical outcomes with predictable relief of pain and improvement in function.…”

Section: Discussionsupporting

confidence: 93%

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

Meftah

John

Lendhey

et al. 2013

The Journal of Arthroplasty

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Section: Discussionsupporting

confidence: 93%

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

Meftah

John

Lendhey

et al. 2013

The Journal of Arthroplasty

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“…10,11). There is, in fact, increasing evidence in the literature suggesting that cementless implants are not contra-indicated in patients of advanced age and can be considered as a safe technique [31,[36][37][38][39][40].…”

Section: Discussionmentioning

confidence: 98%

Good results with an uncoated grit-blasted tapered straight stem at ten years

Zweymüller

2007

Interact Surg

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In the literature, there is no consensus on the value of uncoated cementless femoral stems. We asked whether the results obtained with a grit-blasted titanium surface would prove the usefulness of this implant at an intermediate follow-up time. Three hundred and sixty five patients (376 hips) underwent primary total hip arthroplasty (THA) using the SL-Plus stem in combination with a ceramic-PE articulation. At a minimum follow-up time of 10.0 years (mean 10.2 years; range, 10.0 to 12.6 years), 229 stems (60.9%) were available for analysis. Five revisions were performed, one because of low-grade infection, one because of an aseptic loosening, another one because of a traumatic subsidence and two because of periprosthetic fractures. The 10-year survivorship with revision for any reason as event of interest was 98.3% (95% CI: 96.0%-99.3%). Radiologically two stems were diagnosed to be loosened at follow-up. Osteolytic lesions were detected in 5 patients. The implant survivorship with revision and radiographic sign of loosening as event of interest was 95.7% (95% CI: 89.0%-98.4%) at the time of maximum follow-up (12.6 years). Radiolucent lines (RLs) occurred in 27.9% mostly in positions 1 and 7. In the age group less than 70 years of age, 35% were found to show RLs, in the age group older than 70 years of age only 12.5% showed RLs. The five patients with osteolytic lesions were all from the age group 70 years. These intermediate results document that primary implants with a grit-blasted titanium surface ensure an excellent intermediate-term outcome clinically and with regards to the survival rate. It also confirms our approach not to accept any age limits for selecting patients for cementless THAs. A prospective study will have to show whether additional hydroxyapatite (HA)-coating can improve the radiologic outcome.

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“…These 32 exclusions left 149 patients (160 THAs; two patients excluded had bilateral off-the-shelf implants). Sixty patients (65 THAs) were 70 years and older at the time of surgery with an average age of 75 years (range, 70-86 years) and average body mass index of 27 (range, [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. The minimum followup was 24 months (mean, 35 months; range, 24-60 months).…”

Section: Methodsmentioning

confidence: 99%

Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older

Patel

Smith

Woodward

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Limitations of conventional uncemented femoral stems persist, including proximal-distal mismatch, nonideal load transfer, loss of bone, and difficulties with minimally invasive surgery. Metaphyseal-engaging shortstem implants have been designed to address these issues in THA. While these devices have been studied in younger patients, it is unclear whether they offer advantages in older patients. Questions/purposes We asked whether the stability and bony ingrowth of an off-the-shelf short stem in patients 70 years and older were similar to those achieved in patients younger than 70 years at 2-year followup. Furthermore, we asked whether pain and function scores were affected by age, bone quality, or varus alignment. Patients and Methods We retrospectively reviewed 60 patients (65 hips) 70 years and older (mean, 75 years; range, 70-86 years) treated with an uncemented short stem (range, 90-105 mm). We compared radiographic alignment, stability, and bony ingrowth, as well as Harris hip scores and WOMAC pain scores, to a cohort of 89 patients (91 hips) younger than 70 years. Minimum followup was 24 months (mean, 35 months; range, 24-60 months). Results Radiographs showed proximal bony ingrowth and stable fixation of all implants. Average Harris hip score at last followup was 88 (range, 70-100) for the 70 years and older cohort and 93 (range, 70-100) for younger than 70 years cohort; no patients reported thigh pain. Postoperative WOMAC scores averaged 6 (range, 0-43) and 5 (range, 0-25), respectively.

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Uncemented total hip arthroplasty in the elderly

Cited by 27 publications

References 13 publications

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

Safety and Efficacy of Non-Cemented Femoral Fixation in Patients 75 Years of Age and Older

Good results with an uncoated grit-blasted tapered straight stem at ten years

Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older

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