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Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips

BACKGROUND: The surface texture, localization, and magnitude of the surface material applied to the femoral stem can facilitate bone ingrowth and influence the survival of total hip arthroplasties. Clinical and radiographic studies have shown superior bone ingrowth in proximally porous-coated stems...

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Autores principales: Baad-Hansen, Thomas, Kold, Søren, Olsen, Niels, Christensen, Finn, Søballe, Kjeld
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235308/
https://www.ncbi.nlm.nih.gov/pubmed/21504304
http://dx.doi.org/10.3109/17453674.2011.574562
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author Baad-Hansen, Thomas
Kold, Søren
Olsen, Niels
Christensen, Finn
Søballe, Kjeld
author_facet Baad-Hansen, Thomas
Kold, Søren
Olsen, Niels
Christensen, Finn
Søballe, Kjeld
author_sort Baad-Hansen, Thomas
collection PubMed
description BACKGROUND: The surface texture, localization, and magnitude of the surface material applied to the femoral stem can facilitate bone ingrowth and influence the survival of total hip arthroplasties. Clinical and radiographic studies have shown superior bone ingrowth in proximally porous-coated stems with a diaphyseal grit-blasted surface in comparison to a smooth diaphyseal surface. Surface textures—especially porous surface material—have been suggested to have a sealing effect against migration of polyethylene debris along the implant-bone interface and to reduce the inflammatory response, leading to a prolonged implant survival. PATIENTS AND METHODS: Between 2004 and 2006, we conducted a randomized, controlled trial (RCT) involving 50 patients with non-inflammatory arthritis. They received either a distally tapered, extended coated stem or a straight, proximally coated stem. During surgery, tantalum markers were inserted into the greater and lesser trochanter. Implant migration was evaluated at 3, 12, and 24 months postoperatively by radiostereometric analysis. The primary endpoint was stem migration 2 years after surgery. RESULTS: All femoral components in both groups showed pronounced distal translation, with the highest rate of translation occurring between 0 and 3 months. After 2 years, the mean distal translation was 2.67 (95% CI: –3.93 to –1.42) mm for the tapered, extended coated stem and 1.80 (–2.45 to –1.15) mm for the straight, proximally coated stem. Half of the tapered, extended coated stems and two-thirds of the straight, proximally coated stems had migrated more than 1 mm. No difference between the 2 stems could be seen with regard to translation or rotation at any time point. After 2 years, 2 hips have been reoperated due to mechanical loosening of the stem. INTERPRETATION: An excessive amount of migration of both stem types was seen 2 years postoperatively. It is of vital importance to follow this patient cohort since radiostereometric analysis is known to be predictive of late implant failure, especially in this study where pronounced early migration was observed. We recommend longer follow-up of both stem types.
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spelling pubmed-32353082011-12-16 Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips Baad-Hansen, Thomas Kold, Søren Olsen, Niels Christensen, Finn Søballe, Kjeld Acta Orthop Article BACKGROUND: The surface texture, localization, and magnitude of the surface material applied to the femoral stem can facilitate bone ingrowth and influence the survival of total hip arthroplasties. Clinical and radiographic studies have shown superior bone ingrowth in proximally porous-coated stems with a diaphyseal grit-blasted surface in comparison to a smooth diaphyseal surface. Surface textures—especially porous surface material—have been suggested to have a sealing effect against migration of polyethylene debris along the implant-bone interface and to reduce the inflammatory response, leading to a prolonged implant survival. PATIENTS AND METHODS: Between 2004 and 2006, we conducted a randomized, controlled trial (RCT) involving 50 patients with non-inflammatory arthritis. They received either a distally tapered, extended coated stem or a straight, proximally coated stem. During surgery, tantalum markers were inserted into the greater and lesser trochanter. Implant migration was evaluated at 3, 12, and 24 months postoperatively by radiostereometric analysis. The primary endpoint was stem migration 2 years after surgery. RESULTS: All femoral components in both groups showed pronounced distal translation, with the highest rate of translation occurring between 0 and 3 months. After 2 years, the mean distal translation was 2.67 (95% CI: –3.93 to –1.42) mm for the tapered, extended coated stem and 1.80 (–2.45 to –1.15) mm for the straight, proximally coated stem. Half of the tapered, extended coated stems and two-thirds of the straight, proximally coated stems had migrated more than 1 mm. No difference between the 2 stems could be seen with regard to translation or rotation at any time point. After 2 years, 2 hips have been reoperated due to mechanical loosening of the stem. INTERPRETATION: An excessive amount of migration of both stem types was seen 2 years postoperatively. It is of vital importance to follow this patient cohort since radiostereometric analysis is known to be predictive of late implant failure, especially in this study where pronounced early migration was observed. We recommend longer follow-up of both stem types. Informa Healthcare 2011-06 2011-07-08 /pmc/articles/PMC3235308/ /pubmed/21504304 http://dx.doi.org/10.3109/17453674.2011.574562 Text en Copyright: © Nordic Orthopaedic 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 Article
Baad-Hansen, Thomas
Kold, Søren
Olsen, Niels
Christensen, Finn
Søballe, Kjeld
Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips
title Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips
title_full Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips
title_fullStr Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips
title_full_unstemmed Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips
title_short Excessive distal migration of fiber-mesh coated femoral stems: A randomized RSA study of 41 hips
title_sort excessive distal migration of fiber-mesh coated femoral stems: a randomized rsa study of 41 hips
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235308/
https://www.ncbi.nlm.nih.gov/pubmed/21504304
http://dx.doi.org/10.3109/17453674.2011.574562
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