Artikel
Radiographic analysis of stability after implantation of three different cementless short femoral stems – five year follow-up
Suche in Medline nach
Autoren
-
Wieslaw Lachowicz
- University Hospital of Torrevieja, Torrevieja / Alicante, Spain
-
Pablo Grau
- University Hospital of Torrevieja, Torrevieja / Alicante, Spain
-
Clara Cobo
- University Hospital of Torrevieja, Torrevieja / Alicante, Spain
-
Carmen Medina
- University Hospital of Torrevieja, Torrevieja / Alicante, Germany
-
Maritere Vargas
- University Hospital of Torrevieja, Torrevieja / Alicante, Spain
-
Ireneusz Francuz
- University Hospital of Torrevieja, Torrevieja / Alicante, Spain
-
Damian Jover
- University Hospital of Torrevieja, Torrevieja / Alicante, Spain
-
Kay Berg
- Hospital Universitario del Vinalopó (ELCHE), Elche, Spain
| Veröffentlicht: | 22. Oktober 2019 |
|---|
Gliederung
Text
Objectives: In a five-year follow-up comparative study we will present the outcomes after implantation of three cementless short femoral stems : MINIHIP (Corin), SMF (Smith&Nephew) and FURLONG EVOLUTION (jRi) (Figure 1 [Fig. 1]).
They are uncemented titanium stems shorter than conventional stems and can be implanted through minimally invasive approach.
Methods: We have analized the data of 180 patients (88 females, 92 males), in three groups of 60 patients, each group using a different implant.
The mean age was 66.9 years old (ranging 37 - 84 years).
Using a MINIHIP, SMF and EVOLUTION stem were operated on 93 left (51.7%) and 87 (48.3%) right hips.
Causes for operative treatment were 115 patients with primary coxarthrosis (63.8%), 43 with avascular necrosis of the femoral head (23.8%) and 22 with secondary coxarthrosis (12.2%).
Most of the patients 149 (82.8%) were operated on with a minimal invasive anterior approach (DAA), 28 (15.6%) with postero-lateral and 3 (1.7%) with antero-lateral approach.
The mean follow-up time was 5 years.
The statistical outcomes were analyzed on SPSS program.
Results: Evaluation of the radiographic outcomes was assessed for:
- malalignment: SMF stem 5 cases /2.7%/
- Susbsidence (vertical stem migration) > 2 mm: MINIHIP stem 16 (26.6%) patients, SMF 41 (68.3%) and EVOLUTION stem 4 (6.6%), ANOVA F test P=0.011 (Figure 2B [Fig. 2], Table 1 [Tab. 1])
- anteroposterior angular (varus) stem migration > 2° : MINIHIP stem 11 (18.3%), SMF 45 (75%) and EVOLUTION stem 16 (26.6%), ANOVA F test P = 0.008 (Figure 2A [Fig. 2], Table 2 [Tab. 2])
- axial (lateral) angular stem migration was not statistically significant
- proximal femur neck osteolysis at SMF stem 12 cases /20%/
- distal femur cortical hypertrophy (stress shielding): MINIHIP 10 (16.6%) SMF stem 16 cases (26.6%), EVOLUTION 0. (Fig 2C [Fig. 2])
- periprosthetic fractures: MINIHIP stem 6 (10%) SMF 4 cases /6.7%/ and EVOLUTION stem 2 (3.3%).
Revision of hip arthroplasty was necessary with 6 patients with SMF stem. No revisions at all with MINIHIP or EVOLUTION implants.
Conclusions:
- SMF stem is less stable in comparison to MINIMHIP and EVOLUTION, differences are statistically significant, in vertical (P=0,011) and in angular (P=0,008) migration.
- we didn't find statistically significant differences comparing MINIMHIP and EVOLUTION stems in vertical (P=0.7392) and angular (P=0.4541) migration.
- revision hip arthroplasty was necessary only after implantation of the SMF stem.
- all three stems: MINIHIP, SMF and EVOLUTION can be implanted using minimally invasive direct anterior approach /DAA/.
- all three stems can be replaced using a conventional hip stem if revision hip arthroplasty is necessary.
