Skip to main content
Erschienen in: HSS Journal ® 3/2012

01.10.2012 | Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

Is it Time for Cementless Hip Resurfacing?

verfasst von: Julien Girard, MD, PhD

Erschienen in: HSS Journal ® | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

Metal-on-metal bearing with cemented femoral component and cementless acetabular fixation is the current standard in surface replacement arthroplasty (RSA) of the hip. Because of concerns about the long-term survivorship of cemented stems in conventional hip arthroplasty, it seems logical to achieve cementless fixation on the femoral side with RSA.

Questions/Purposes

The goals of this review were to evaluate clinical and radiological data reported from previously published cementless RSA series. In addition, we intend to review author’s preliminary experience with Conserve Plus cementless devices specifically assessing the clinical outcomes, the complications rate, the survivorship, and the metallic ions levels measured in follow-up.

Methods

A references search was done with PubMed using the key words “cementless hip resurfacing”, “cementless hip resurfacing prosthesis”, and “femoral cementless hip resurfacing”. Additionally, the clinical outcomes, the complications rate, the survivorship, and the metallic ions levels were measured in 94 cementless Conserve Plus© devices in 90 patients (68 males and 22 females) with a mean age of 41.1 years (18–59). Mean follow-up was 13.1 months (8–16).

Results

No revision was performed during the observed follow-up. Neither radiological signs of loosening nor neck narrowing >10% were evident. Chromium and cobalt levels in whole blood samples rose respectively from 0.53 μg/l (0.1–1.7) to 1.7 μg/l (0.6–2.9) and from 0.54 μg/l (0.1–1.4) to 1.98 μg/l (0.1–2.8).

Conclusions

Cementless “fit and fill” femoral-side fixation, which seems to be potentially evolved and design-related, should be considered for future hip-resurfacing device generations.
Literatur
1.
Zurück zum Zitat Baker R, Whitehouse M, Kilshaw M, Pabbruwe M, Spencer R, Blom A, Bannister G. Maximum temperatures of 89 °C recorded during the mechanical preparation of 35 femoral heads for resurfacing. Acta Orthop. 2011; 82: 669–73PubMedCrossRef Baker R, Whitehouse M, Kilshaw M, Pabbruwe M, Spencer R, Blom A, Bannister G. Maximum temperatures of 89 °C recorded during the mechanical preparation of 35 femoral heads for resurfacing. Acta Orthop. 2011; 82: 669–73PubMedCrossRef
2.
Zurück zum Zitat Chandler HP, Reineck FT, Wixson RL, McCarthy JC. Total hip replacement in patients younger than thirty years old. A five-year follow-up study. J. Bone Joint Surg. Am. 1981; 63: 1426–34PubMed Chandler HP, Reineck FT, Wixson RL, McCarthy JC. Total hip replacement in patients younger than thirty years old. A five-year follow-up study. J. Bone Joint Surg. Am. 1981; 63: 1426–34PubMed
3.
Zurück zum Zitat de Waal Malefijt MC, Huiskes R. A clinical, radiological and biomechanical study of the TARA hip prosthesis. Arch Orthop. Trauma Surg. 1993; 112: 205–20CrossRef de Waal Malefijt MC, Huiskes R. A clinical, radiological and biomechanical study of the TARA hip prosthesis. Arch Orthop. Trauma Surg. 1993; 112: 205–20CrossRef
4.
Zurück zum Zitat Fern ED, Norton MR. Is neck resorption a problem after hip resurfacing? Read at the 2007 Young Arthritic Hip Meeting, October 11–13, 2007, Vienna, Austria Fern ED, Norton MR. Is neck resorption a problem after hip resurfacing? Read at the 2007 Young Arthritic Hip Meeting, October 11–13, 2007, Vienna, Austria
5.
Zurück zum Zitat Girard J, Bocquet D, Autissier G, Fouilleron N, Migaud H. Metal-on-Metal hip arthroplasty in patients thirty years of age or younger. J. Bone Joint Surg. Am. 2010; 92: 2419–26PubMedCrossRef Girard J, Bocquet D, Autissier G, Fouilleron N, Migaud H. Metal-on-Metal hip arthroplasty in patients thirty years of age or younger. J. Bone Joint Surg. Am. 2010; 92: 2419–26PubMedCrossRef
6.
Zurück zum Zitat Girard J, Glorion C, Bonnomet F, Fron D, Migaud H. Risk factors for revision of hip arthroplasties in patients younger than 30 years. Clin. Orthop. Relat. Res. 2011; 469: 1141–7PubMedCrossRef Girard J, Glorion C, Bonnomet F, Fron D, Migaud H. Risk factors for revision of hip arthroplasties in patients younger than 30 years. Clin. Orthop. Relat. Res. 2011; 469: 1141–7PubMedCrossRef
7.
Zurück zum Zitat Gross TP, Liu F. Is there added risk in resurfacing a femoral head with cysts? J. Orthop. Surg. Res. 2011; 17: 55–6CrossRef Gross TP, Liu F. Is there added risk in resurfacing a femoral head with cysts? J. Orthop. Surg. Res. 2011; 17: 55–6CrossRef
8.
Zurück zum Zitat Gross TP, Liu F. The first 100 fully porous-coated femoral components in hip resurfacing. Bull. N.Y.U. Hosp. Jt. Dis. 2011; 69: 30–5 Gross TP, Liu F. The first 100 fully porous-coated femoral components in hip resurfacing. Bull. N.Y.U. Hosp. Jt. Dis. 2011; 69: 30–5
9.
Zurück zum Zitat Gross TP, Liu F. Metal-on-metal hip resurfacing with an uncemented femoral component. A seven-year follow-up study. J. Bone Joint Surg. Am. 2008; 90: S32–7CrossRef Gross TP, Liu F. Metal-on-metal hip resurfacing with an uncemented femoral component. A seven-year follow-up study. J. Bone Joint Surg. Am. 2008; 90: S32–7CrossRef
10.
Zurück zum Zitat Gross TP. Variations and new designs. Uncemented heads. Read at the 4th Hip Resurfacing Course, June 16–19, 2010, Gand, Belgium Gross TP. Variations and new designs. Uncemented heads. Read at the 4th Hip Resurfacing Course, June 16–19, 2010, Gand, Belgium
11.
Zurück zum Zitat Hing CB, Young DA, Dalziel RE, Bailey M, Back DL, Shimmin AJ. Narrowing of the neck in resurfacing arthroplasty of the hip: a radiological study. J. Bone Joint Surg. Br. 2007; 89: 1019–24PubMed Hing CB, Young DA, Dalziel RE, Bailey M, Back DL, Shimmin AJ. Narrowing of the neck in resurfacing arthroplasty of the hip: a radiological study. J. Bone Joint Surg. Br. 2007; 89: 1019–24PubMed
12.
Zurück zum Zitat Hull P, Baxter JA, Lewis C, Kordas G, Foguet P, Prakash U. Metal-on-metal hip resurfacing with uncemented fixation of the femoral component. A minimum 2 year follow up. Hip Int. 2011; 21: 475–8PubMedCrossRef Hull P, Baxter JA, Lewis C, Kordas G, Foguet P, Prakash U. Metal-on-metal hip resurfacing with uncemented fixation of the femoral component. A minimum 2 year follow up. Hip Int. 2011; 21: 475–8PubMedCrossRef
13.
Zurück zum Zitat Johnson AJ, Zywiel MG, Hooper H, Mont MA. Narrowed indications improve outcomes for hip resurfacing arthroplasty. Bull. N.Y.U. Hosp. Jt. Dis. 2011; 69: 27–9 Johnson AJ, Zywiel MG, Hooper H, Mont MA. Narrowed indications improve outcomes for hip resurfacing arthroplasty. Bull. N.Y.U. Hosp. Jt. Dis. 2011; 69: 27–9
14.
Zurück zum Zitat Katrana P, Crawford JR, Vowler S, Lilikakis A, Villar RN. Femoral neck resorption after hip resurfacing arthroplasty—a comparison of cemented and uncemented prostheses. J. Bone Joint Surg. Br. 2006; 88: S234CrossRef Katrana P, Crawford JR, Vowler S, Lilikakis A, Villar RN. Femoral neck resorption after hip resurfacing arthroplasty—a comparison of cemented and uncemented prostheses. J. Bone Joint Surg. Br. 2006; 88: S234CrossRef
15.
Zurück zum Zitat Lerch M, Olender G, Angrisani N, Rittershaus D, Meyer-Lindenberg A, Thorey F, Windhagen H, Hurschler C. The impact of seating forces from a cementless femoral component in hip resurfacing arthroplasty on the femoral head—a cadaver study using μ-CT analysis. Technol. Health Care 2011; 19: 29–36PubMed Lerch M, Olender G, Angrisani N, Rittershaus D, Meyer-Lindenberg A, Thorey F, Windhagen H, Hurschler C. The impact of seating forces from a cementless femoral component in hip resurfacing arthroplasty on the femoral head—a cadaver study using μ-CT analysis. Technol. Health Care 2011; 19: 29–36PubMed
16.
Zurück zum Zitat Lilikakis AK, Vowler SL, Villar RN. Hydroxyapatite-coated femoral implant in metal-on-metal resurfacing hip arthroplasty: minimum of two years follow-up. Orthop. Clin. North Am. 2005; 36: 215–22PubMedCrossRef Lilikakis AK, Vowler SL, Villar RN. Hydroxyapatite-coated femoral implant in metal-on-metal resurfacing hip arthroplasty: minimum of two years follow-up. Orthop. Clin. North Am. 2005; 36: 215–22PubMedCrossRef
17.
Zurück zum Zitat Little JP, Gray HA, Murray DW, Beard DJ, Gill HS. Thermal effects of cement mantle thickness for hip resurfacing. J. Arthroplasty 2008; 23: 454–8PubMedCrossRef Little JP, Gray HA, Murray DW, Beard DJ, Gill HS. Thermal effects of cement mantle thickness for hip resurfacing. J. Arthroplasty 2008; 23: 454–8PubMedCrossRef
18.
Zurück zum Zitat Lord GA, Hardy JR, Kummer FJ. An uncemented total hip replacement: experimental study and review of 300 madreporique arthroplasties. Clin. Orthop. Relat. Res. 1979; 141: 2–16PubMed Lord GA, Hardy JR, Kummer FJ. An uncemented total hip replacement: experimental study and review of 300 madreporique arthroplasties. Clin. Orthop. Relat. Res. 1979; 141: 2–16PubMed
19.
Zurück zum Zitat Mazzullo S, Paolini M, Verdi C. Numerical simulation of thermal bone necrosis during cementation of femoral prostheses. J. Math. Biol. 1991 29: 475–94PubMedCrossRef Mazzullo S, Paolini M, Verdi C. Numerical simulation of thermal bone necrosis during cementation of femoral prostheses. J. Math. Biol. 1991 29: 475–94PubMedCrossRef
20.
Zurück zum Zitat Migaud H, Putman S, Krantz N, Vasseur L, Girard J. Cementless metal-on-metal versus ceramic-on-polyethylene hip arthroplasty in patients less than 50 years of age: a comparative study at 12- to 14-year follow-up. J. Bone Joint Surg. Am. 2011; 93: 137–42PubMedCrossRef Migaud H, Putman S, Krantz N, Vasseur L, Girard J. Cementless metal-on-metal versus ceramic-on-polyethylene hip arthroplasty in patients less than 50 years of age: a comparative study at 12- to 14-year follow-up. J. Bone Joint Surg. Am. 2011; 93: 137–42PubMedCrossRef
21.
Zurück zum Zitat Mjöberg B. Loosening of the cemented hip prosthesis. The importance of heat injury. Acta Orthop. Scand. 1986; 221:1–40 Mjöberg B. Loosening of the cemented hip prosthesis. The importance of heat injury. Acta Orthop. Scand. 1986; 221:1–40
22.
Zurück zum Zitat Scheerlinck T, Delport H, Kiewitt T. Influence of the cementing technique on the cement mantle in hip resurfacing: an in vitro computed tomography scan-based analysis. J. Bone Joint Surg. Am. 2010; 92: 375–87PubMedCrossRef Scheerlinck T, Delport H, Kiewitt T. Influence of the cementing technique on the cement mantle in hip resurfacing: an in vitro computed tomography scan-based analysis. J. Bone Joint Surg. Am. 2010; 92: 375–87PubMedCrossRef
23.
Zurück zum Zitat Spencer RF. Evolution in hip resurfacing design and contemporary experience with an uncemented device. J. Bone Joint Surg. Am. 2011; 93: 84–8PubMedCrossRef Spencer RF. Evolution in hip resurfacing design and contemporary experience with an uncemented device. J. Bone Joint Surg. Am. 2011; 93: 84–8PubMedCrossRef
24.
Zurück zum Zitat Spencer RF. Hip resurfacing, UK experience. Eighth Symposium on Joint Preserving and Minimally Invasive Surgery of the Hip, June 10–12, 2010, Ottawa, Canada Spencer RF. Hip resurfacing, UK experience. Eighth Symposium on Joint Preserving and Minimally Invasive Surgery of the Hip, June 10–12, 2010, Ottawa, Canada
25.
Zurück zum Zitat Takamura KM, Yoon J, Ebramzadeh E, Campbell PA, Amstutz HC. Incidence and significance of femoral neck narrowing in the first 500 Conserve® Plus series of hip resurfacing cases: a clinical and histologic study. Orthop. Clin. North Am. 2011; 42: 181–93PubMedCrossRef Takamura KM, Yoon J, Ebramzadeh E, Campbell PA, Amstutz HC. Incidence and significance of femoral neck narrowing in the first 500 Conserve® Plus series of hip resurfacing cases: a clinical and histologic study. Orthop. Clin. North Am. 2011; 42: 181–93PubMedCrossRef
26.
Zurück zum Zitat Villar R. BHR versus Cormet hip resurfacing masterclass. Read at the Hip Resurfacing Symposium, July 5–6, 2007, Oswestry, U.K. Villar R. BHR versus Cormet hip resurfacing masterclass. Read at the Hip Resurfacing Symposium, July 5–6, 2007, Oswestry, U.K.
27.
Zurück zum Zitat Wagner M, Wagner H. Preliminary results of uncemented metal on metal stemmed and resurfacing hip replacement arthroplasty. Clin. Orthop. Relat. Res.1996; 329: S78–88PubMedCrossRef Wagner M, Wagner H. Preliminary results of uncemented metal on metal stemmed and resurfacing hip replacement arthroplasty. Clin. Orthop. Relat. Res.1996; 329: S78–88PubMedCrossRef
28.
Zurück zum Zitat Watanabe Y, Shiba N, Matsuo S, Higuchi F, Tagawa Y, Inoue A. Biomechanical study of the resurfacing hip arthroplasty: finite element analysis of the femoral component. J. Arthroplasty 2000; 15: 505–11PubMedCrossRef Watanabe Y, Shiba N, Matsuo S, Higuchi F, Tagawa Y, Inoue A. Biomechanical study of the resurfacing hip arthroplasty: finite element analysis of the femoral component. J. Arthroplasty 2000; 15: 505–11PubMedCrossRef
Metadaten
Titel
Is it Time for Cementless Hip Resurfacing?
verfasst von
Julien Girard, MD, PhD
Publikationsdatum
01.10.2012
Verlag
Springer-Verlag
Erschienen in
HSS Journal ® / Ausgabe 3/2012
Print ISSN: 1556-3316
Elektronische ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-012-9295-7

Weitere Artikel der Ausgabe 3/2012

HSS Journal ® 3/2012 Zur Ausgabe

Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

Ideal Femoral Head Size in Total Hip Arthroplasty Balances Stability and Volumetric Wear

Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

Neck-Preserving Femoral Stems

Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

An Algorithmic Approach to Mechanical Hip Pain

Arthropedia

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

Update Orthopädie und Unfallchirurgie

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