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Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem
INTRODUCTION: Fully hydroxyapatite-coated titanium alloy double-tapered stems have been successful implant designs for THA. The Novation Element Stem (Exactech, Gainesville, FL) is one of several of these implants following a modified Corail design philosophy. Although a great deal is known about th...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892108/ https://www.ncbi.nlm.nih.gov/pubmed/35239021 http://dx.doi.org/10.1007/s00402-022-04393-6 |
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author | Yakkanti, Ramakanth R. Greif, Dylan N. Berge, Dennis J. Vanden Robinson, Raymond P. |
author_facet | Yakkanti, Ramakanth R. Greif, Dylan N. Berge, Dennis J. Vanden Robinson, Raymond P. |
author_sort | Yakkanti, Ramakanth R. |
collection | PubMed |
description | INTRODUCTION: Fully hydroxyapatite-coated titanium alloy double-tapered stems have been successful implant designs for THA. The Novation Element Stem (Exactech, Gainesville, FL) is one of several of these implants following a modified Corail design philosophy. Although a great deal is known about the results of the Corail stem, little is known about the more recent Corail-inspired implants. The authors evaluated the clinical outcomes, radiographic findings and survival statistics of the collarless version of the Element Stem when used routinely in a diverse patient population. METHODS: A retrospective review was performed for all primary THR cases from 2010 to 2018. Patient demographics and HHS/OHS/patient satisfaction scores were obtained. Radiographs were evaluated for stem subsidence, radiolucencies, and bone responses to the implant. RESULTS: One hundred and fifty seven Element Stems were implanted with greater than 2 years of radiographic follow-up, while 105 Element Stems implanted during the study period had a survival of 5 years or more. Average HHS was 91.7 and average OHS was 44.0. 54 of 157 hips had radiolucencies, all of which included a proximal zonal radiolucency. Average subsidence was 3.33 mm; 18 hips had subsidence > 4 mm. There were 8 revisions for: aseptic loosening (4), trauma-related peri-prosthetic fractures, and early proximal–medial fractures. At 5 years, the all-cause survival rate is 92.4%, 96.2% based only on aseptic loosening and 98.1% based only on proximal medial fractures. CONCLUSION: Clinical outcomes using the collarless Novation Element Stem are good, but early proximal medial fracture is still a factor in patients with poor-quality bone. Proximal radiolucencies progressing to aseptic loosening post-operatively are also a concern. The 11.5% rate of subsidence is comparable to other fully HA-coated collarless stems. This study provides a thorough critical analysis of outcomes and midterm survival data of this dual tapered-wedge fully HA-coated collarless stem used routinely in a diverse patient population. |
format | Online Article Text |
id | pubmed-8892108 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-88921082022-03-04 Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem Yakkanti, Ramakanth R. Greif, Dylan N. Berge, Dennis J. Vanden Robinson, Raymond P. Arch Orthop Trauma Surg Hip Arthroplasty INTRODUCTION: Fully hydroxyapatite-coated titanium alloy double-tapered stems have been successful implant designs for THA. The Novation Element Stem (Exactech, Gainesville, FL) is one of several of these implants following a modified Corail design philosophy. Although a great deal is known about the results of the Corail stem, little is known about the more recent Corail-inspired implants. The authors evaluated the clinical outcomes, radiographic findings and survival statistics of the collarless version of the Element Stem when used routinely in a diverse patient population. METHODS: A retrospective review was performed for all primary THR cases from 2010 to 2018. Patient demographics and HHS/OHS/patient satisfaction scores were obtained. Radiographs were evaluated for stem subsidence, radiolucencies, and bone responses to the implant. RESULTS: One hundred and fifty seven Element Stems were implanted with greater than 2 years of radiographic follow-up, while 105 Element Stems implanted during the study period had a survival of 5 years or more. Average HHS was 91.7 and average OHS was 44.0. 54 of 157 hips had radiolucencies, all of which included a proximal zonal radiolucency. Average subsidence was 3.33 mm; 18 hips had subsidence > 4 mm. There were 8 revisions for: aseptic loosening (4), trauma-related peri-prosthetic fractures, and early proximal–medial fractures. At 5 years, the all-cause survival rate is 92.4%, 96.2% based only on aseptic loosening and 98.1% based only on proximal medial fractures. CONCLUSION: Clinical outcomes using the collarless Novation Element Stem are good, but early proximal medial fracture is still a factor in patients with poor-quality bone. Proximal radiolucencies progressing to aseptic loosening post-operatively are also a concern. The 11.5% rate of subsidence is comparable to other fully HA-coated collarless stems. This study provides a thorough critical analysis of outcomes and midterm survival data of this dual tapered-wedge fully HA-coated collarless stem used routinely in a diverse patient population. Springer Berlin Heidelberg 2022-03-03 2023 /pmc/articles/PMC8892108/ /pubmed/35239021 http://dx.doi.org/10.1007/s00402-022-04393-6 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Hip Arthroplasty Yakkanti, Ramakanth R. Greif, Dylan N. Berge, Dennis J. Vanden Robinson, Raymond P. Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem |
title | Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem |
title_full | Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem |
title_fullStr | Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem |
title_full_unstemmed | Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem |
title_short | Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem |
title_sort | survival and performance of a dual tapered-wedge fully ha-coated press fit femoral stem |
topic | Hip Arthroplasty |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892108/ https://www.ncbi.nlm.nih.gov/pubmed/35239021 http://dx.doi.org/10.1007/s00402-022-04393-6 |
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