Failure of total hip arthroplasty with a precoated prosthesis. 4- to 11-year results
| Autor: | Charles W. Cha, Ick Hwan Yang, Harry E. Rubash, Shin-Yoon Kim, Sunil Trakru, James E. Dowd |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
musculoskeletal diseases
Male Reoperation medicine.medical_specialty Osteolysis Time Factors Radiography medicine.medical_treatment Arthroplasty Replacement Hip Prosthesis Design Prosthesis Coated Materials Biocompatible Medicine Humans Polymethyl Methacrylate Orthopedics and Sports Medicine Femur Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Bone Cements General Medicine equipment and supplies medicine.disease Survival Analysis Surgery Biomechanical Phenomena Prosthesis Failure Causality Equipment Failure Analysis Femoral prosthesis surgical procedures operative Orthopedic surgery Female Hip Prosthesis business Complication Total hip arthroplasty |
| Zdroj: | Clinical orthopaedics and related research. (355) |
| ISSN: | 0009-921X |
| Popis: | A series of early femoral component failures prompted a detailed retrospective clinical and radiographic review of 176 hybrid cemented total hip arthroplasties using a polymethyl-methacrylate coated femoral prosthesis. All surgeries were performed using third generation cement techniques. Average length of followup was 6.3 years (range, 3-12 years). Twenty-one patients died, and one underwent revision surgery because of sepsis. Of the remaining 154 total hip arthroplasties, 23 (15%) of the femoral components failed (21 revised, two definitely loose). The average time to revision was 3.9 years. None of the acetabular components failed. Comparison between the failure and nonfailure groups revealed that poor cement mantles (Grades C or D) with distal cement mantle deficiencies were statistically significant predictors of femoral failure. The most common mechanism of failure was progressive, circumferential cement-bone interface osteolysis with relative preservation of the cement-metal interface. Debonding of the cement column from the prosthesis was a late finding and occurred in only 45% of failed cases. Incorporating the techniques of centralization and centrifugation significantly improved clinical results. Strengthening of the cement-prosthesis interface may magnify the deleterious effects of a poor cement mantle and predisposes the cement-bone interface to failure. |
| Databáze: | OpenAIRE |
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