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01.11.2009 | Symposium: Selected Papers Presented at the 2008 Meeting of the Musculoskeletal Tumor Society | Ausgabe 11/2009

Clinical Orthopaedics and Related Research® 11/2009

Early Equivalence of Uncemented Press-fit and Compress® Femoral Fixation

Zeitschrift:
Clinical Orthopaedics and Related Research® > Ausgabe 11/2009
Autoren:
MD German L. Farfalli, MD Patrick J. Boland, MD Carol D. Morris, MD Edward A. Athanasian, MD John H. Healey
Wichtige Hinweise
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his institution has approved the reporting of this study and that all investigations were conducted in conformity with ethical principles of research.

Abstract

Bone ingrowth promises more durable biologic fixation of megaprostheses. The relative performance of different types of fixation is unknown. We compared the fixation of two forms of biologically fixed femoral components: an intramedullary uncemented press-fit stem (UCS; Group 1, 50 patients) and a Compress® uncemented fixation (CPS; Group 2, 41 patients). In Group 1, the overall Kaplan-Meier prosthetic survival rates were 85% at 5 and 71% at 10 years. Most failures were long-term developments. Aseptic loosening was the primary cause of failure. Stem diameters less than 13.5 mm and a diaphyseal/stem coefficient greater than 2.5 mm were associated with decreased prosthetic survival. In Group 2, the overall rate of CPS survival was 88% at 5 years. Failure of femoral fixation or fracture during the first year was the main reason for revision. Five-year survival rates were similar between the groups and we observed no difference in the functional success of the implants. We found no failures after 1-year followup in Group 2 (CPS). Any difference in prosthetic survival can only be proven by longer-term study or a randomized trial.
Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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