Influence of Design Variations on Early Migration of a Cemented Stem in THA
| Autor: | Johan Kärrholm, Georgios Digas, Kent Olofsson |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Arthroplasty Replacement Hip medicine.medical_treatment Prosthesis Design Prosthesis Radiostereometric Analysis Foreign-Body Migration Humans Medicine Orthopedics and Sports Medicine Prospective Studies Prospective cohort study Aged Fixation (histology) Aged 80 and over Orthodontics biology business.industry General Medicine Middle Aged Prognosis biology.organism_classification Arthroplasty Prosthesis Failure Surgery Valgus Orthopedic surgery Female Hip Prosthesis Implant business Follow-Up Studies |
| Zdroj: | Clinical Orthopaedics and Related Research. 448:67-72 |
| ISSN: | 0009-921X |
| Popis: | UNLABELLED: The clinical results of using different cemented stems in total hip arthroplasty may vary because of shape, surface finish, and choice of metal alloy. Less is known about the influence of size and offset using one and the same design. Data from 140 patients (140 hips) of a cohort constituting 197 patients (231 hips) implanted with cemented Spectron Primary stems were extracted from patients studied in four randomized studies primarily designed for other purposes. Stem size (1, 2, 3, or larger), normal/extra offset, neck length and true offset (horizontal length between the stem and head center of the inserted modular implant) were recorded in millimeters. The radiographic appearance of the cementing was graded on the immediate postoperative radiograph according to Barrack. The patients were examined with radiostereometric analysis of stem migration for a 2-year followup period. Stem Size 1 (the smallest) showed an insignificant increase in subsidence compared with the bigger sizes. Using stepwise linear regression analysis, the quality of the cementing (Barrack C2) was the only parameter that had any certain influence of the subsidence at 2 years. Stem size 2 tended to show minimum valgus alignment and sizes 1 and 3 and bigger showed minimum varus tilting. Our findings suggest that placement of the stem with the tip against the posterior cortex (C2) and stem size influence the primary fixation in different ways. This effect is small, however, indicating that further confirmation with longer followup is necessary. LEVEL OF EVIDENCE: Therapeutic Level II-1 (prospective cohort study). See the Guidelines for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|