Short-term outcomes in total hip arthroplasties using second-generation metaphyseal fixation stems
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Published:
Aug 3, 2020
Keywords:
Arthroplasty, uncemented prosthesis, metaphyseal fixation
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Abstract
Introduction: The high number of total hip arthroplasties (THAs) currently being performed in young patients warrants a thorough understanding of THA survivorship. Femoral component stability and resistance to subsidence are critical factors to achieve correct osseointegration, and the subsequent clinical success, in uncemented THAs. Materials and Methods: We conducted an observational, descriptive, retrospective study on all patients who underwent primary total hip replacement performed by our surgical team between December 2017 and May 2018. We identified the patients who received second-generation metaphyseal fixation stems (Group 2). Group 2 results were then compared with our database of patients who received first-generation stems (Group 1). Results: Group 1: 82 THAs, of which, after a 1-year postoperative follow-up, 2 patients (2.44%) had complications, which were noted during surgery (a calcar fracture and a false route caused while preparing the femoral canal). Group 2: 49 THAs, 1 patient (2%) required femoral stem revision, due to aseptic loosening, 5 months after primary THA. Conclusions: In our experience, secondgeneration implants achieve clinical outcomes comparable to those obtained with first-generation implants, while also decreasing the risk of intraoperative complications associated with the placement of the implant. This method has shown to be reproducible and to have an easy learning curve for experienced surgeons.
Level of Evidence: IV
Level of Evidence: IV
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How to Cite
Bochatey, E. J., & Lopreite, F. A. (2020). Short-term outcomes in total hip arthroplasties using second-generation metaphyseal fixation stems. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(3), 214-221. https://doi.org/10.15417/issn.1852-7434.2020.85.3.1021
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Clinical Research
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References
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femoral component: a long-term study of the taperloc stem. J Arthroplasty 2004;19(6):151-6.
https://doi.org/10.1016/j.arth.2003.10.003
3. Casper DS, Kim GK, Restrepo C, Parvizi J, Rothman RH. Primary total hip arthroplasty with an uncemented
femoral component. Five-to nine-year results. J Arthroplasty 2011;26(6):838-41. https://doi.org/10.1016/j.arth.2011.02.010
4. Hernández Cortes P, Nájera Sagastume OO, Mesa Ramos F, Pajares López M, Hernández Hernández MA.
Hydroxyapatite-coated stems with metaphyseal and diaphyseal press-fit. Eleven-year follow-up results. Acta Orthop Belg 2002;68(1):24-32. PMID: 11915455
5. Streit MR, Innmann MM, Merle C, Bruckner T, Aldinger PR, Gotterbam T. Long-term (20- to 25-year) results
of an uncemented tapered titanium femoral component and factors affecting survivorship. Clin Orthop Relat Res
2013;471(10):3262-9. https://doi.org/10.1007/s11999-013-3033-4
6. Pilliar RM, Lee JM, Maniatopoulos C. Observation on the effect of movement on bone ingrowth into poroussurfaced implants. Clin Orthop 1986;(208):108-13. PMID: 3720113
7. Capello WN, D´Antonio JA, Jaffe WL, Geesink RG, Manley MT Feinberg JR. Hydroxyapatite-coated femoral
components: 15-year minimum followup. Clin Orthop 2006;453:75-80. https://doi.org/10.1097/01.blo.0000246534.44629.b2
8. Hwang K-T, Kim Y-H, Kim Y-S, Choi I-Y. Total hip arthroplasty using cementless grit-blasted femoral component: a minimum 10-year follow-up study. J Arthroplasty 2012;27(8):1554-61. https://doi.org/10.1016/j.arth.2012.02.005
9. Dalton J, Cook SD, Thomas KA, Kay JF. The effect of operative fit and hydroxyapatite coating on the mechanical
and biological response to porous implants. J Bone Joint Surg Am 1995;77(1):97-110.
https://doi.org/10.2106/00004623-199501000-00012
10. Faizan A, Wuestemann T, Nevelos J, Bastian AC, Collopy D. Development and verification of a cementless novel tapered wedge stem for total hip arthroplasty. J Arthroplasty 2014;30(2):235-40.
https://doi.org/10.1016/j.arth.2014.09.023
11. Issa K, Pivec R, Wuestemann T, Tatevossian T, Nevelos J Mont MA. Radiographic fit and fill analysis of a
new second-generation proximally coated cementless stem compared to its predicate design. J Arthroplasty
2014;29(1):192-8. https://doi.org/10.1016/j.arth.2013.04.029
12. Colacchio N, Robbins C, Aghazadeh M, Talmo C, Bono J. Total hip intraoperative femur fracture: does a tapered wedge design with a size specific medial curvature reduce the incidence of intraoperative femur fracture? J Arthroplasty 2017;32(10):3163-8. https://doi.org/10.1016/j.arth.2017.05.012
13. Kolisek FR, Chughtai M, Mistry JB, Elmallah RK, Jaggard C, Malkani AL, et al. Outcomes of second-generation
tapered wedge femoral stem. Surg Technol Int 2016;28:275-9. PMID: 27042781
14. Cooper HJ, Rodríguez J. Early post-operative periprosthetic femur fracture in the presence of a non-cemented
tapered wedge femoral stem. HSS J 2010;6(2):150-4. https://doi.org/10.1007/s11420-010-9161-4
2. Parvizi J, Keisu KS, Hozack WJ, Sharkey PF, Rothman RH. Primary total hip arthroplasty with an uncemented
femoral component: a long-term study of the taperloc stem. J Arthroplasty 2004;19(6):151-6.
https://doi.org/10.1016/j.arth.2003.10.003
3. Casper DS, Kim GK, Restrepo C, Parvizi J, Rothman RH. Primary total hip arthroplasty with an uncemented
femoral component. Five-to nine-year results. J Arthroplasty 2011;26(6):838-41. https://doi.org/10.1016/j.arth.2011.02.010
4. Hernández Cortes P, Nájera Sagastume OO, Mesa Ramos F, Pajares López M, Hernández Hernández MA.
Hydroxyapatite-coated stems with metaphyseal and diaphyseal press-fit. Eleven-year follow-up results. Acta Orthop Belg 2002;68(1):24-32. PMID: 11915455
5. Streit MR, Innmann MM, Merle C, Bruckner T, Aldinger PR, Gotterbam T. Long-term (20- to 25-year) results
of an uncemented tapered titanium femoral component and factors affecting survivorship. Clin Orthop Relat Res
2013;471(10):3262-9. https://doi.org/10.1007/s11999-013-3033-4
6. Pilliar RM, Lee JM, Maniatopoulos C. Observation on the effect of movement on bone ingrowth into poroussurfaced implants. Clin Orthop 1986;(208):108-13. PMID: 3720113
7. Capello WN, D´Antonio JA, Jaffe WL, Geesink RG, Manley MT Feinberg JR. Hydroxyapatite-coated femoral
components: 15-year minimum followup. Clin Orthop 2006;453:75-80. https://doi.org/10.1097/01.blo.0000246534.44629.b2
8. Hwang K-T, Kim Y-H, Kim Y-S, Choi I-Y. Total hip arthroplasty using cementless grit-blasted femoral component: a minimum 10-year follow-up study. J Arthroplasty 2012;27(8):1554-61. https://doi.org/10.1016/j.arth.2012.02.005
9. Dalton J, Cook SD, Thomas KA, Kay JF. The effect of operative fit and hydroxyapatite coating on the mechanical
and biological response to porous implants. J Bone Joint Surg Am 1995;77(1):97-110.
https://doi.org/10.2106/00004623-199501000-00012
10. Faizan A, Wuestemann T, Nevelos J, Bastian AC, Collopy D. Development and verification of a cementless novel tapered wedge stem for total hip arthroplasty. J Arthroplasty 2014;30(2):235-40.
https://doi.org/10.1016/j.arth.2014.09.023
11. Issa K, Pivec R, Wuestemann T, Tatevossian T, Nevelos J Mont MA. Radiographic fit and fill analysis of a
new second-generation proximally coated cementless stem compared to its predicate design. J Arthroplasty
2014;29(1):192-8. https://doi.org/10.1016/j.arth.2013.04.029
12. Colacchio N, Robbins C, Aghazadeh M, Talmo C, Bono J. Total hip intraoperative femur fracture: does a tapered wedge design with a size specific medial curvature reduce the incidence of intraoperative femur fracture? J Arthroplasty 2017;32(10):3163-8. https://doi.org/10.1016/j.arth.2017.05.012
13. Kolisek FR, Chughtai M, Mistry JB, Elmallah RK, Jaggard C, Malkani AL, et al. Outcomes of second-generation
tapered wedge femoral stem. Surg Technol Int 2016;28:275-9. PMID: 27042781
14. Cooper HJ, Rodríguez J. Early post-operative periprosthetic femur fracture in the presence of a non-cemented
tapered wedge femoral stem. HSS J 2010;6(2):150-4. https://doi.org/10.1007/s11420-010-9161-4