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Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT

Background and purpose According to the manual of the cementless Link MP reconstruction prosthesis, a distal femoral stem-bone anchorage of at least 80 mm is necessary to gain implant stability. There have been no in vivo studies showing that this distance is either achieved in clinical practice or...

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Autores principales: Weiss, Rüdiger J, Strömwall, Fredrik, Beckman, Mats O, Hansson, Karl A, Stark, André
Formato: Texto
Lenguaje:English
Publicado: Informa Healthcare 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823214/
https://www.ncbi.nlm.nih.gov/pubmed/19593722
http://dx.doi.org/10.3109/17453670903039403
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author Weiss, Rüdiger J
Strömwall, Fredrik
Beckman, Mats O
Hansson, Karl A
Stark, André
author_facet Weiss, Rüdiger J
Strömwall, Fredrik
Beckman, Mats O
Hansson, Karl A
Stark, André
author_sort Weiss, Rüdiger J
collection PubMed
description Background and purpose According to the manual of the cementless Link MP reconstruction prosthesis, a distal femoral stem-bone anchorage of at least 80 mm is necessary to gain implant stability. There have been no in vivo studies showing that this distance is either achieved in clinical practice or needed for clinically satisfying results. Thus, we assessed the femoral stem-bone anchorage of the MP prosthesis using CT. Methods 14 patients with the MP stem were evaluated by CT scans at a median follow-up time of 12 months postoperatively. Femoral stem-bone anchorage was defined as adequate if 50% of the stem flutes or more had cortical bone contact. The length of anchorage was derived from the number of slices with adequate anchorage. Clinical outcome was assessed with VAS for pain and Harris hip score (HHS), both at 1 and 5 years of follow-up. Results The median length of stem-bone anchorage was 33 mm (interquartile range 10–60), which was shorter than recommended (p = 0.002). Still, at the 1-year control, all patients were fully weight-bearing and only 1/14 complained about mild thigh pain. 7/14 patients did not experience any pain in the affected hip. The patients had a median of 85 points in the HHS. The clinical outcome at 5 years was unchanged. Interpretation We found that it can be difficult to achieve a stem-bone anchorage of at least 80 mm for the MP Link prosthesis. However, this does not appear to be necessary to obtain stability and to achieve clinically satisfying results.
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spelling pubmed-28232142010-02-18 Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT Weiss, Rüdiger J Strömwall, Fredrik Beckman, Mats O Hansson, Karl A Stark, André Acta Orthop Research Article Background and purpose According to the manual of the cementless Link MP reconstruction prosthesis, a distal femoral stem-bone anchorage of at least 80 mm is necessary to gain implant stability. There have been no in vivo studies showing that this distance is either achieved in clinical practice or needed for clinically satisfying results. Thus, we assessed the femoral stem-bone anchorage of the MP prosthesis using CT. Methods 14 patients with the MP stem were evaluated by CT scans at a median follow-up time of 12 months postoperatively. Femoral stem-bone anchorage was defined as adequate if 50% of the stem flutes or more had cortical bone contact. The length of anchorage was derived from the number of slices with adequate anchorage. Clinical outcome was assessed with VAS for pain and Harris hip score (HHS), both at 1 and 5 years of follow-up. Results The median length of stem-bone anchorage was 33 mm (interquartile range 10–60), which was shorter than recommended (p = 0.002). Still, at the 1-year control, all patients were fully weight-bearing and only 1/14 complained about mild thigh pain. 7/14 patients did not experience any pain in the affected hip. The patients had a median of 85 points in the HHS. The clinical outcome at 5 years was unchanged. Interpretation We found that it can be difficult to achieve a stem-bone anchorage of at least 80 mm for the MP Link prosthesis. However, this does not appear to be necessary to obtain stability and to achieve clinically satisfying results. Informa Healthcare 2009-06-05 2009-06-01 /pmc/articles/PMC2823214/ /pubmed/19593722 http://dx.doi.org/10.3109/17453670903039403 Text en Copyright: © Nordic Orthopedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Research Article
Weiss, Rüdiger J
Strömwall, Fredrik
Beckman, Mats O
Hansson, Karl A
Stark, André
Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT
title Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT
title_full Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT
title_fullStr Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT
title_full_unstemmed Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT
title_short Distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: Evaluation of 14 patients by CT
title_sort distal femoral stem-bone anchorage of a cementless revision total hip arthroplasty: evaluation of 14 patients by ct
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823214/
https://www.ncbi.nlm.nih.gov/pubmed/19593722
http://dx.doi.org/10.3109/17453670903039403
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