nach oben

International Orthopaedics

Erschienen in:

01.05.2012 | Original Paper

Subsidence of a cementless femoral component influenced by body weight and body mass index

verfasst von: Christoph Stihsen, Roman Radl, Armin Keshmiri, Peter Rehak, Reinhard Windhager

Erschienen in: International Orthopaedics | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This trial was designed to evaluate the impact of physical characteristics such as body mass index, body weight and height on distal stem migration of a cementless femoral component, as the influence of obesity on the outcome of THA is still debated in literature and conflicting results have been found.

Methods

In this retrospective cohort study, migration patterns for 102 implants were analysed using the Einzel-Bild-Roentgen-Analyse (EBRA-FCA, femoral component analysis). In all cases the Vision 2000 stem was implanted and combined with the Duraloc acetabular component (DePuy, Warsaw, Indiana).

Results

The mean follow-up was 93 months. EBRA-FCA evaluations revealed a mean subsidence of 1.38 mm after two years, 2.06 mm after five and 2.24 mm after seven years. Five stems loosened aseptically. Correlation between increased migration over the whole period and aseptic loosening was highly significant (p < 0.001). Surgical technique had a significant influence on migration and stem stability (p = 0.002) but physical patient characteristics such as body weight over 75 kg and height over 165 cm also significantly influenced stem subsidence towards progressive migration (p = 0.001, p < 0.001). However, a high BMI did not trigger progressive stem migration (p = 0.87). Being of the male gender raised the odds for increased migration (p = 0.03).

Conclusion

Physical characteristics such as body weight and height showed significant influence on migration patterns of this cementless femoral component. The operating surgeon should be aware that body weight above 75 kg and height over 165 cm may trigger increased stem migration and the surgeon should aim to fit these prostheses as tightly as possible. However this study demonstrates that a high BMI does not trigger progressive stem migration. Further investigations are needed to confirm our findings.

Clohisy JC, Calvert G, Tull F, McDonald D, Maloney WJ (2004) Reasons for revision hip surgery: a retrospective review. Clin Orthop Relat Res 429:188–192PubMedCrossRef

Böhm P, Bischel O (2001) Femoral revision with the Wagner SL revision stem: evaluation of one hundred and twenty-nine revisions followed for a mean of 4.8 years. J Bone Joint Surg Am 83:1023–1031PubMedCrossRef

Sundfeldt M, Carlsson LV, Johansson CB, Thomsen P, Gretzer C (2006) Aseptic loosening, not only a question of wear: a review of different theories. Acta Orthop 77:177–197PubMedCrossRef

Münger P, Röder C, Ackermann-Liebrich U, Busato A (2006) Patient-related risk factors leading to aseptic stem loosening in total hip arthroplasty: a case-control study of 5,035 patients. Acta Orthop 77:567–574PubMedCrossRef

Andrew JG, Palan J, Kurup HV, Gibson P, Murray DW, Beard DJ (2005) Obesity in total hip replacement. J Bone Joint Surg Br 90:424–429

Moran M, Walmsley P, Gray A, Brenkel IJ (2005) Does body mass index affect the early outcome of primary total hip arthroplasty. J Arthroplasty 20:866–869PubMedCrossRef

Jackson MP, Sexton SA, Yeung E, Walter WL, Walter WK, Zicat BA (2009) The effect of obesity on the mid-term survival and clinical outcome of cementless total hip replacement. J Bone Joint Surg Br 91:1296–1300PubMedCrossRef

Haverkamp D, de Man FH, de Jong PT, van Stralen RA, Marti RK (2008) Is the long-term outcome of cemented THA jeopardized by patients being overweight? Clin Orthop Relat Res 466:1162–1168PubMedCrossRef

McLaughlin JR, Lee KR (2006) The outcome of total hip replacement in obese and non-obese patients at 10- to 18-years. J Bone Joint Surg Br 88:1286–1292PubMedCrossRef

10.

Ibrahim T, Hobson S, Beiri A, Esler CN (2005) No influence of body mass index on early outcome following total hip arthroplasty. Int Orthop 29:359–361PubMedCrossRef

11.

Young NL, Cheah D, Waddell JP, Wright JG (1998) Patient characteristics that affect the outcome of total hip arthroplasty: a review. Can J Surg 41:188–195PubMed

12.

Surin VV, Sundholm K (1983) Survival of patients and prostheses after total hip arthroplasty. Clin Orthop Relat Res 177:148–153PubMed

13.

Olsson SS, Jernberger A, Tryggö D (1981) Clinical and radiological long-term results after Charnley-Müller total hip replacement. A 5 to 10 year follow-up study with special reference to aseptic loosening. Acta Orthop Scand 52:531–542PubMedCrossRef

14.

Chandler HP, Reineck FT, Wixson RL, McCarthy JC (1981) Total hip replacement in patients younger than thirty years old. A five-year follow-up study. J Bone Joint Surg Am 63:1426–1434PubMed

15.

Friedl G, Radl R, Stihsen C, Rehak P, Aigner R, Windhager R (2009) The effect of a single infusion of zoledronic acid on early implant migration in total hip arthroplasty. A randomized, double-blind, controlled trial. J Bone Joint Surg Am 91:274–281PubMedCrossRef

16.

Onsten I, Akesson K, Besjakov J, Obrant KJ (1995) Migration of the Charnley stem in rheumatoid arthritis and osteoarthritis. A roentgen stereophotogrammetric study. J Bone Joint Surg Br 77:18–22PubMed

17.

Krismer M, Bauer R, Tschupik J, Mayrhofer P (1995) EBRA: a method to measure migration of acetabular components. J Biomech 28:1225–1236PubMedCrossRef

18.

Biedermann R, Krismer M, Stöckl B, Mayrhofer P, Ornstein E, Franzén H (1999) Accuracy of EBRA-FCA in the measurement of migration of femoral components of total hip replacement. Einzel-Bild-Roentgen-Analyse-femoral component analysis. J Bone Joint Surg Br 81:266–272PubMedCrossRef

19.

Fender D, van der Meulen JH, Gregg PJ (2003) Relationship between outcome and annual surgical experience for the charnley total hip replacement. Results from a regional hip register. J Bone Joint Surg Br 85:187–190PubMedCrossRef

20.

Malchau H, Herberts P, Ahnfelt L (1993) Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978–1990. Acta Orthop Scand 64:497–506PubMedCrossRef

21.

Søballe K, Christensen F, Luxhøj T (1987) Hip replacement in obese patients. Acta Orthop Scand 58:223–225PubMedCrossRef

22.

Dickob M, Martini T (1996) The cementless PM hip arthroplasty. Four-to-seven-year results. J Bone Joint Surg Br 78:195–199PubMed

23.

Röder C, Parvizi J, Eggli S, Berry DJ, Müller ME, Busato A (2003) Demographic factors affecting long-term outcome of total hip arthroplasty. Clin Orthop Relat Res 417:62–73PubMed

24.

Röder C, Eggli S, Münger P, Melloh M, Busato A (2008) Patient characteristics differently affect early cup and stem loosening in THA: a case-control study on 7,535 patients. Int Orthop 32:33–38PubMedCrossRef

25.

Selvik G (1989) Roentgen stereophotogrammetry. A method for the study of the kinematics of the skeletal system. Acta Orthop Scand Suppl 232:1–51

Titel: Subsidence of a cementless femoral component influenced by body weight and body mass index
verfasst von: Christoph Stihsen
Roman Radl
Armin Keshmiri
Peter Rehak
Reinhard Windhager
Publikationsdatum: 01.05.2012
Verlag: Springer-Verlag
Erschienen in: International Orthopaedics / Ausgabe 5/2012
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-011-1360-1

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2012

Remission after treatment of osteoarticular infections due to Pseudomonas aeruginosa versus Staphylococcus aureus: a case-controlled study

Erratum to: Thromboprophylaxis in patients older than 75 years or with moderate renal impairment undergoing knee or hip replacement surgery

Results of forty two computer-assisted double level osteotomies for severe genu varum deformity

Bone marrow-derived mesenchymal stem cells versus bone marrow nucleated cells in the treatment of chondral defects

The Bicontact cementless primary total hip arthroplasty: long-term results

Comment on Stern et al.: Prospective randomised study comparing screw versus helical blade in the treatment of low-energy trochanteric fractures