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Erschienen in: Archives of Orthopaedic and Trauma Surgery 7/2014

01.07.2014 | Hip Arthroplasty

Migration pattern of a femoral short-stem prosthesis: a 2-year EBRA-FCA-study

verfasst von: Tobias Freitag, Thomas Kappe, Michael Fuchs, Sebastian Jung, Heiko Reichel, Ralf Bieger

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 7/2014

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Abstract

Introduction

Short-stem prostheses enable bone stock preserving total hip arthroplasty. However, little is known about the durability of this group of implants. The most common cause for implant failure is aseptic loosening. Early implant migration is supposed to be the best indicator for mechanical failure of femoral stems. The purpose of this study was to evaluate the migration pattern of a short stem implant and the influence of BMI, gender and femoral offset on implant migration.

Materials and methods

After a minimum follow-up of 2 years, 72 hips were included in this EBRA-FCA-study. The mean age at surgery of the 34 female and 32 male patients was 54 years (range 22–75 years). The mean BMI was 29 kg/m2 (range 21–51 kg/m2).

Results

Mean axial subsidence was 1 mm (±1.4 mm) after 24 months. BMI, gender and implant offset did not influence implant migration on a statistical significant level. Nevertheless, a tendency towards more migration in obese and female patients was observed.

Conclusion

The evaluated short stem prosthesis showed a migration pattern similar to clinical proven standard straight stem implants. The indication of short-stem prostheses should be critically evaluated in obese and female patients.
Literatur
1.
Zurück zum Zitat Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet 370(9597):1508–1519PubMedCrossRef Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet 370(9597):1508–1519PubMedCrossRef
2.
Zurück zum Zitat Kärrholm J, Garellick G, Rogmark C, Rolfson O, Herberts P (2012) Swedish HIP Arthroplasty Register: annual report 2011. Sahlgrenska University Hospital, Sahlgrenska Kärrholm J, Garellick G, Rogmark C, Rolfson O, Herberts P (2012) Swedish HIP Arthroplasty Register: annual report 2011. Sahlgrenska University Hospital, Sahlgrenska
3.
Zurück zum Zitat Coulter G, Young DA, Dalziel RE, Shimmin AJ (2012) Birmingham hip resurfacing at a mean of ten years: results from an independent centre. J Bone Jt Surg Br 94(3):315–321CrossRef Coulter G, Young DA, Dalziel RE, Shimmin AJ (2012) Birmingham hip resurfacing at a mean of ten years: results from an independent centre. J Bone Jt Surg Br 94(3):315–321CrossRef
5.
Zurück zum Zitat Johanson PE, Fenstad AM, Furnes O, Garellick G, Havelin LI, Overgaard S et al ((2010)) Inferior outcome after hip resurfacing arthroplasty than after conventional arthroplasty. Evidence from the Nordic Arthroplasty Register Association (NARA) database, 1995 to 2007. Acta Orthop 81(5):535–541CrossRef Johanson PE, Fenstad AM, Furnes O, Garellick G, Havelin LI, Overgaard S et al ((2010)) Inferior outcome after hip resurfacing arthroplasty than after conventional arthroplasty. Evidence from the Nordic Arthroplasty Register Association (NARA) database, 1995 to 2007. Acta Orthop 81(5):535–541CrossRef
6.
Zurück zum Zitat AQUA (2012) Hüftendoprothesenversorgung. Göttingen: AQUA—Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH AQUA (2012) Hüftendoprothesenversorgung. Göttingen: AQUA—Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH
7.
Zurück zum Zitat Khanuja HS, Vakil JJ, Goddard MS, Mont MA (2011) Cementless femoral fixation in total hip arthroplasty. J Bone Jt Surg Am 93(5):500–509CrossRef Khanuja HS, Vakil JJ, Goddard MS, Mont MA (2011) Cementless femoral fixation in total hip arthroplasty. J Bone Jt Surg Am 93(5):500–509CrossRef
8.
Zurück zum Zitat Bieger R, Ignatius A, Decking R, Claes L, Reichel H, Durselen L ((2012)) Primary stability and strain distribution of cementless hip stems as a function of implant design. Clin Biomech (Bristol, Avon) 27(2):158–164CrossRef Bieger R, Ignatius A, Decking R, Claes L, Reichel H, Durselen L ((2012)) Primary stability and strain distribution of cementless hip stems as a function of implant design. Clin Biomech (Bristol, Avon) 27(2):158–164CrossRef
9.
Zurück zum Zitat Krismer M, Biedermann R, Stockl B, Fischer M, Bauer R, Haid C (1999) The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-analyse-femoral component analysis. J Bone Jt Surg Br 81(2):273–280CrossRef Krismer M, Biedermann R, Stockl B, Fischer M, Bauer R, Haid C (1999) The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-analyse-femoral component analysis. J Bone Jt Surg Br 81(2):273–280CrossRef
10.
Zurück zum Zitat Bieger R, Ignatius A, Reichel H, Durselen L (2013) Biomechanics of a short stem: in vitro primary stability and stress shielding of a conservative cementless hip stem. J Orthop Res 31(8):1180–1186PubMedCrossRef Bieger R, Ignatius A, Reichel H, Durselen L (2013) Biomechanics of a short stem: in vitro primary stability and stress shielding of a conservative cementless hip stem. J Orthop Res 31(8):1180–1186PubMedCrossRef
11.
Zurück zum Zitat Karrholm J (2012) Radiostereometric analysis of early implant migration—a valuable tool to ensure proper introduction of new implants. Acta Orthop 83(6):551–552PubMedCentralPubMedCrossRef Karrholm J (2012) Radiostereometric analysis of early implant migration—a valuable tool to ensure proper introduction of new implants. Acta Orthop 83(6):551–552PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Karrholm J, Herberts P, Hultmark P, Malchau H, Nivbrant B, Thanner J (1997) Radiostereometry of hip prostheses. Review of methodology and clinical results. Clin Orthop Relat Res 344:94–110PubMed Karrholm J, Herberts P, Hultmark P, Malchau H, Nivbrant B, Thanner J (1997) Radiostereometry of hip prostheses. Review of methodology and clinical results. Clin Orthop Relat Res 344:94–110PubMed
13.
Zurück zum Zitat Biedermann R, Krismer M, Stockl B, Mayrhofer P, Ornstein E, Franzen H (1999) Accuracy of EBRA-FCA in the measurement of migration of femoral components of total hip replacement. Einzel-Bild-Rontgen-analyse-femoral component analysis. J Bone Jt Surg Br 81(2):266–272CrossRef Biedermann R, Krismer M, Stockl B, Mayrhofer P, Ornstein E, Franzen H (1999) Accuracy of EBRA-FCA in the measurement of migration of femoral components of total hip replacement. Einzel-Bild-Rontgen-analyse-femoral component analysis. J Bone Jt Surg Br 81(2):266–272CrossRef
14.
Zurück zum Zitat Wilkinson JM, Hamer AJ, Elson RA, Stockley I, Eastell R (2002) Precision of EBRA-digital software for monitoring implant migration after total hip arthroplasty. J Arthroplast 17(7):910–916CrossRef Wilkinson JM, Hamer AJ, Elson RA, Stockley I, Eastell R (2002) Precision of EBRA-digital software for monitoring implant migration after total hip arthroplasty. J Arthroplast 17(7):910–916CrossRef
15.
Zurück zum Zitat Lazarinis S, Mattsson P, Milbrink J, Mallmin H, Hailer NP (2013) A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA: primary stability but no prevention of proximal bone loss in 27 patients followed for 2 years. Acta Orthop 84(1):32–39PubMedCentralPubMedCrossRef Lazarinis S, Mattsson P, Milbrink J, Mallmin H, Hailer NP (2013) A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA: primary stability but no prevention of proximal bone loss in 27 patients followed for 2 years. Acta Orthop 84(1):32–39PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Schmidutz F, Graf T, Mazoochian F, Fottner A, Bauer-Melnyk A, Jansson V (2012) Migration analysis of a metaphyseal anchored short-stem hip prosthesis. Acta Orthop 83(4):360–365PubMedCentralPubMedCrossRef Schmidutz F, Graf T, Mazoochian F, Fottner A, Bauer-Melnyk A, Jansson V (2012) Migration analysis of a metaphyseal anchored short-stem hip prosthesis. Acta Orthop 83(4):360–365PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Floerkemeier T, Tscheuschner N, Calliess T, Ezechieli M, Floerkemeier S, Budde S et al (2012) Cementless short stem hip arthroplasty METHA(R) as an encouraging option in adults with osteonecrosis of the femoral head. Arch Orthop Trauma Surg 132(8):1125–1131PubMedCrossRef Floerkemeier T, Tscheuschner N, Calliess T, Ezechieli M, Floerkemeier S, Budde S et al (2012) Cementless short stem hip arthroplasty METHA(R) as an encouraging option in adults with osteonecrosis of the femoral head. Arch Orthop Trauma Surg 132(8):1125–1131PubMedCrossRef
18.
Zurück zum Zitat Ruben RB, Fernandes PR, Folgado J (2012) On the optimal shape of hip implants. J Biomech 45(2):239–246PubMedCrossRef Ruben RB, Fernandes PR, Folgado J (2012) On the optimal shape of hip implants. J Biomech 45(2):239–246PubMedCrossRef
19.
Zurück zum Zitat Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95(1–2):47–49PubMedCrossRef Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95(1–2):47–49PubMedCrossRef
20.
Zurück zum Zitat Morrey BF, Adams RA, Kessler M (2000) A conservative femoral replacement for total hip arthroplasty. A prospective study. J Bone Jt Surg Br 82(7):952–958CrossRef Morrey BF, Adams RA, Kessler M (2000) A conservative femoral replacement for total hip arthroplasty. A prospective study. J Bone Jt Surg Br 82(7):952–958CrossRef
21.
Zurück zum Zitat Gustke K ((2012)) Short stems for total hip arthroplasty: Initial experience with the Fitmore stem. J Bone Jt Surg Br 94-B(11 Suppl):47–51CrossRef Gustke K ((2012)) Short stems for total hip arthroplasty: Initial experience with the Fitmore stem. J Bone Jt Surg Br 94-B(11 Suppl):47–51CrossRef
22.
Zurück zum Zitat Wolf O, Mattsson P, Milbrink J, Larsson S, Mallmin H (2010) Periprosthetic bone mineral density and fixation of the uncemented CLS stem related to different weight bearing regimes: a randomized study using DXA and RSA in 38 patients followed for 5 years. Acta Orthop 81(3):286–291PubMedCentralPubMedCrossRef Wolf O, Mattsson P, Milbrink J, Larsson S, Mallmin H (2010) Periprosthetic bone mineral density and fixation of the uncemented CLS stem related to different weight bearing regimes: a randomized study using DXA and RSA in 38 patients followed for 5 years. Acta Orthop 81(3):286–291PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat Jacobs CA, Christensen CP (2009) Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty. Int Orthop 33(4):917–922PubMedCentralPubMedCrossRef Jacobs CA, Christensen CP (2009) Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty. Int Orthop 33(4):917–922PubMedCentralPubMedCrossRef
24.
Zurück zum Zitat Patel RM, Smith MC, Woodward CC, Stulberg SD (2012) Stable fixation of short-stem femoral implants in patients 70 years and older. Clin Orthop Relat Res 470(2):442–449PubMedCentralPubMedCrossRef Patel RM, Smith MC, Woodward CC, Stulberg SD (2012) Stable fixation of short-stem femoral implants in patients 70 years and older. Clin Orthop Relat Res 470(2):442–449PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Rohrl SM, Li MG, Pedersen E, Ullmark G, Nivbrant B (2006) Migration pattern of a short femoral neck preserving stem. Clin Orthop Relat Res 448:73–78PubMedCrossRef Rohrl SM, Li MG, Pedersen E, Ullmark G, Nivbrant B (2006) Migration pattern of a short femoral neck preserving stem. Clin Orthop Relat Res 448:73–78PubMedCrossRef
Metadaten
Titel
Migration pattern of a femoral short-stem prosthesis: a 2-year EBRA-FCA-study
verfasst von
Tobias Freitag
Thomas Kappe
Michael Fuchs
Sebastian Jung
Heiko Reichel
Ralf Bieger
Publikationsdatum
01.07.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 7/2014
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-014-1984-x

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