nach oben

Erschienen in:

02.04.2020 | Leitthema

Long-term results of custom-made femoral stems

verfasst von: Christophe Jacquet, MD, Xavier Flecher, MD, PhD, Charles Pioger, MD, Maxime Fabre-Aubrespy, MD, Matthieu Ollivier, MD, PhD, Jean-Noel Argenson, MD, PhD

Erschienen in: Die Orthopädie | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

The progress of 3D imaging and manufacturing of implants has made it possible to achieve a custom-made concept in THA. The custom-made cementless femoral stem provides optimal implant stability combined with restoration of the native hip mechanics.

Objective

The purpose of this study was to evaluate the long-term survivorship of custom-made hip femoral stems in two populations of patients undergoing THA: patients under 50 years old (young patients group) and patients with high-grade developmental dysplasia of the hip (DDH group).

Methods

A series of 232 primary custom-made cementless THA stems were retrospectively evaluated in patients less than 50 years old at the time of surgery and at follow-up after an average of 20 years. A second series of 26 custom-made cementless stem THAs for late DDH (21 patients) including only Crowe grade III and grade IV were also retrospectively evaluated with an average follow-up of 16 years. The clinical and radiological evaluations were performed preoperatively and at yearly intervals.

Results

For the young patient group, the follow-up ranged from 14 to 27 years. The HHS and the Merle D’Aubigne-Postel score significantly improved from preoperatively to a mean of 94.1 (range 48–100) and 15.9 (range 9–18), respectively. Taking stem revision for aseptic loosening as an endpoint, survivorship was 96.8% at 20 years (95% confidence interval, CI 95.1–98.5). For the DDH group, the follow-up ranged from 10 to 22 years. The mean HHS increased significantly from preoperative 49 ± 22 points to the most recent follow-up examination with 86 13 points and survivorship was 96.1% (95% CI, 92.7–99.9).

Conclusion

Custom-made femoral stems provide good functional outcome and long-term survivorship in two specific populations of patients undergoing THAs: patients under 50 years old with high expectations and patients with high-grade DDH.

Amstutz HC, Sakai DN (1975) Total joint replacement for ankylosed hips. Indications , technique, and preliminary results. J Bone Joint Surg Am 57:619–625CrossRef

Argenson J‑N, Ryembault E, Flecher X et al (2005) Three-dimensional anatomy of the hip in osteoarthritis after developmental dysplasia. J Bone Joint Surg Br 87:1192–1196. https://doi.org/10.1302/0301-620X.87B9.15928 CrossRefPubMed

Asayama I, Chamnongkich S, Simpson KJ et al (2005) Reconstructed hip joint position and abductor muscle strength after total hip arthroplasty. J Arthroplasty 20:414–420. https://doi.org/10.1016/j.arth.2004.01.016 CrossRefPubMed

Beaulé PE, Dorey FJ, Hoke R et al (2006) The value of patient activity level in the outcome of total hip arthroplasty. J Arthroplasty 21:547–552. https://doi.org/10.1016/j.arth.2005.09.004 CrossRefPubMed

Binazzi R (2015) Two-stage progressive femoral lowering followed by cementless total hip arthroplasty for treating Crowe IV-Hartofilakidis type 3 developmental dysplasia of the hip. J Arthroplasty 30:790–796. https://doi.org/10.1016/j.arth.2014.12.019 CrossRefPubMed

Bugbee WD, Culpepper WJ, Engh CA, Engh CA (1997) Long-term clinical consequences of stress-shielding after total hip arthroplasty without cement. J Bone Joint Surg Am 79:1007–1012. https://doi.org/10.2106/00004623-199707000-00006 CrossRefPubMed

Capello WN, D’Antonio JA, Feinberg JR, Manley MT (2003) Ten-year results with hydroxyapatite-coated total hip femoral components in patients less than fifty years old. A concise follow-up of a previous report. J Bone Joint Surg Am 85:885–889. https://doi.org/10.2106/00004623-200305000-00017 CrossRefPubMed

Charnley J, Feagin JA (1973) Low-friction arthroplasty in congenital subluxation of the hip. Clin Orthop. https://doi.org/10.1097/00003086-197303000-00015 CrossRefPubMed

Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15–23CrossRef

10.

D’aubigne RM, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36-A:451–475CrossRef

11.

De Kam DCJ, Busch VJJF, Veth RPH, Schreurs BW (2011) Total hip arthroplasties in young patients under 50 years: limited evidence for current trends. A descriptive literature review. Hip Int 21:518–525. https://doi.org/10.5301/HIP.2011.8641 CrossRefPubMed

12.

Del Piccolo N, Carubbi C, Mazzotta A et al (2016) Return to sports activity with short stems or standard stems in total hip arthroplasty in patients less than 50 years old. Hip Int 26(Suppl 1):48–51. https://doi.org/10.5301/hipint.5000404 CrossRefPubMed

13.

Engh CA, Bobyn JD (1988) The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop 231:7–28

14.

Eskelinen A, Remes V, Helenius I et al (2005) Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register. 4,661 primary replacements followed for 0–22 years. Acta Orthop 76:28–41. https://doi.org/10.1080/00016470510030292 CrossRefPubMed

15.

Eskelinen A, Remes V, Ylinen P et al (2009) Cementless total hip arthroplasty in patients with severely dysplastic hips and a previous Schanz osteotomy of the femur: techniques, pitfalls, and long-term outcome. Acta Orthop 80:263–269. https://doi.org/10.3109/17453670902967273 CrossRefPubMedPubMedCentral

16.

Flecher X, Argenson JN, Parratte S et al (2006) Custom cementless stem for osteoarthritis following developmental hip dysplasia. Rev Chir Orthop Reparatrice Appar Mot 92:332–342. https://doi.org/10.1016/s0035-1040(06)75763-4 CrossRefPubMed

17.

Flecher X, Parratte S, Aubaniac J‑M, Argenson J‑N (2007) Three-dimensional custom-designed cementless femoral stem for osteoarthritis secondary to congenital dislocation of the hip. J Bone Joint Surg Br 89:1586–1591. https://doi.org/10.1302/0301-620X.89B12.19252 CrossRefPubMed

18.

Götze C, Steens W, Vieth V et al (2002) Primary stability in cementless femoral stems: custom-made versus conventional femoral prosthesis. Clin Biomech 17:267–273. https://doi.org/10.1016/s0268-0033(02)00012-8 CrossRef

19.

Gruen TA, McNeice GM, Amstutz HC (1979) „Modes of failure“ of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 141:17–27

20.

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755CrossRef

21.

Hartofilakidis G, Karachalios T, Georgiades G, Kourlaba G (2011) Total hip arthroplasty in patients with high dislocation: a concise follow-up, at a minimum of fifteen years, of previous reports. J Bone Joint Surg Am 93:1614–1618. https://doi.org/10.2106/JBJS.J.00875 CrossRefPubMed

22.

Kwon Y‑M, Khormaee S, Liow MHL et al (2016) Asymptomatic pseudotumors in patients with taper corrosion of a dual-taper modular femoral stem: MARS-MRI and metal Ion study. J Bone Joint Surg Am 98:1735–1740. https://doi.org/10.2106/JBJS.15.01325 CrossRefPubMed

23.

Lee SJ, Yoo JJ, Kim HJ (2017) Cementless total hip arthroplasty involving trochanteric osteotomy without subtrochanteric shortening for high hip dislocation. Clin Orthop Surg 9:19–28. https://doi.org/10.4055/cios.2017.9.1.19 CrossRefPubMedPubMedCentral

24.

Maar DC, Mont MA, Krackow KA, Hungerford DS (1992) Long-term (twelve to eighteen-year) follow-up of cemented total hip replacements in patients who were less than fifty years old. A follow-up note. J Bone Joint Surg Am 74:307–308CrossRef

25.

Massin P, Geais L, Astoin E et al (2000) The anatomic basis for the concept of lateralized femoral stems: a frontal plane radiographic study of the proximal femur. J Arthroplasty 15:93–101CrossRef

26.

McGrory BJ, Morrey BF, Cahalan TD et al (1995) Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Joint Surg Br 77:865–869CrossRef

27.

Mu W, Yang D, Xu B et al (2016) Midterm outcome of cementless total hip arthroplasty in Crowe IV-Hartofilakidis type III developmental dysplasia of the hip. J Arthroplasty 31:668–675. https://doi.org/10.1016/j.arth.2015.10.011 CrossRefPubMed

28.

Muirhead-Allwood SK, Sandiford N, Skinner JA et al (2010) Uncemented custom computer-assisted design and manufacture of hydroxyapatite-coated femoral components: survival at 10 to 17 years. J Bone Joint Surg Br 92:1079–1084. https://doi.org/10.1302/0301-620X.92B8.23123 CrossRefPubMed

29.

Mutlu T, Çiçek H, Yalçin N et al (2016) How do different designs of femoral stem affect total hip arthroplasty applied to Crowe type III and type IV dysplastic hips. Hip Int 26:374–379. https://doi.org/10.5301/hipint.5000360 CrossRefPubMed

30.

Ollivier M, Abdel MP, Krych AJ et al (2016) Long-term results of total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe IV developmental dysplasia. J Arthroplasty 31:1756–1760. https://doi.org/10.1016/j.arth.2016.01.049 CrossRefPubMed

31.

Paavilainen T, Hoikka V, Paavolainen P (1993) Cementless total hip arthroplasty for congenitally dislocated or dysplastic hips. Technique for replacement with a straight femoral component. Clin Orthop 297:71–81

32.

Sariali E, Klouche S, Mamoudy P (2014) Ceramic-on-ceramic total hip arthroplasty: is squeaking related to an inaccurate three-dimensional hip anatomy reconstruction? Orthop Traumatol Surg Res 100:437–440. https://doi.org/10.1016/j.otsr.2014.01.009 CrossRefPubMed

33.

Sariali E, Klouche S, Mouttet A, Pascal-Moussellard H (2014) The effect of femoral offset modification on gait after total hip arthroplasty. Acta Orthop 85:123–127. https://doi.org/10.3109/17453674.2014.889980 CrossRefPubMedPubMedCentral

34.

Sariali E, Mouttet A, Pasquier G, Durante E (2009) Three-dimensional hip anatomy in osteoarthritis. Analysis of the femoral offset. J Arthroplasty 24:990–997. https://doi.org/10.1016/j.arth.2008.04.031 CrossRefPubMed

35.

Swarup I, Lee Y, Christoph EI et al (2015) Implant survival and patient-reported outcomes after total hip arthroplasty in young patients with juvenile idiopathic arthritis. J Arthroplasty 30:398–402. https://doi.org/10.1016/j.arth.2014.09.018 CrossRefPubMed

36.

Tsiampas DT, Pakos EE, Georgiadis GC, Xenakis TA (2016) Custom-made femoral implants in total hip arthroplasty due to congenital disease of the hip: a review. Hip Int 26:209–214. https://doi.org/10.5301/hipint.5000355 CrossRefPubMed

37.

Wang D, Li L‑L, Wang H‑Y et al (2017) Long-term results of cementless total hip arthroplasty with subtrochanteric shortening osteotomy in Crowe type IV developmental dysplasia. J Arthroplasty 32:1211–1219. https://doi.org/10.1016/j.arth.2016.11.005 CrossRefPubMed

38.

Yoon PW, Kim JI, Kim DO et al (2013) Cementless total hip arthroplasty for patients with Crowe type III or IV developmental dysplasia of the hip: two-stage total hip arthroplasty following skeletal traction after soft tissue release for irreducible hips. Clin Orthop Surg 5:167–173. https://doi.org/10.4055/cios.2013.5.3.167 CrossRefPubMedPubMedCentral

39.

Zenz P, Pospisil C, Fertschak W, Schwägerl W (1995) 10 years of cementless implantation of total hip endoprosthesis using Zweymüller’s stem. Z Orthop Ihre Grenzgeb 133:558–561. https://doi.org/10.1055/s-2008-1039939 CrossRefPubMed

40.

Zhu J, Shen C, Chen X et al (2015) Total hip arthroplasty with a non-modular conical stem and transverse subtrochanteric osteotomy in treatment of high dislocated hips. J Arthroplasty 30:611–614. https://doi.org/10.1016/j.arth.2014.11.002 CrossRefPubMed

Titel: Long-term results of custom-made femoral stems
verfasst von: Christophe Jacquet, MD
Xavier Flecher, MD, PhD
Charles Pioger, MD
Maxime Fabre-Aubrespy, MD
Matthieu Ollivier, MD, PhD
Jean-Noel Argenson, MD, PhD
Publikationsdatum: 02.04.2020
Verlag: Springer Medizin
Erschienen in: Die Orthopädie / Ausgabe 5/2020
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI: https://doi.org/10.1007/s00132-020-03901-z

Arthropedia

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

Neu im Fachgebiet Orthopädie und Unfallchirurgie

25.04.2024 | Hypertonie | Nachrichten

Update Orthopädie und Unfallchirurgie

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

Newsletter bestellen

Springer Medizin

Long-term results of custom-made femoral stems

Abstract

Background

Objective

Methods

Results

Conclusion

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie

Springer Medizin

Abstract

Background

Objective

Methods

Results

Conclusion

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

Weitere Artikel der Ausgabe 5/2020

Warum individuelle Schäfte am Hüftgelenk?

Erratum zu: Hüftgelenkersatz im tagesklinischen Setup

Individuell angepasster Beckenteilersatz in der Hüftgelenksrevision

Kniegelenknahe Amputationen

Individualisierte Schulterendoprothetik: aktueller Stand der Entwicklung

Effekte und Nachhaltigkeit des Kniekollegs

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie