Long-term survival and complication rate of cementless prosthetic stems in primary total hip arthroplasty categorized by types according to Mont classification: a regional registry-based study on 53,626 implants.
Complication
Design
Mont classification
Stem
Surface area
Survival
THA
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
19 Dec 2023
19 Dec 2023
Historique:
received:
05
08
2023
accepted:
11
11
2023
medline:
19
12
2023
pubmed:
19
12
2023
entrez:
19
12
2023
Statut:
aheadofprint
Résumé
The purpose of this retrospective registry-based study is to assess survival and causes of failure of cementless stem implants used in total hip arthroplasty (THAs), to ascertain if there are differences when these are categorized according to the six types described by Mont. Data collected from the regional registry regarding all primary THAs performed from 2000 to 2019 were analyzed. Femoral prosthetic stems were divided into the six types of Mont classification. For each stem type, number of implants, survival and causes of failure were evaluated and compared. The most frequently implanted stem type was the 3c type (53.4%). Type 1 had the lowest stem failure rate (1.6%), and type 6 showed the highest (3.9%). Periprosthetic fracture was the most frequent complication in type 6, accounting for 34.5% of failures. Aseptic loosening was the main complication in type 2 stems, accounting for 36.4% of failures. Pairwise comparisons showed significant higher survival of type 1 compared to type 3c (p = 0.000026) and type 6 (p = 0.000076), and between type 3a compared to type 3c (p = 0.03) and type 6 (p = 0.026). Significant variations in implant survival rates were found among the six Mont-types of cementless stems. These findings emphasize the paramount importance of stem design and fixation area in determining long-term survival, providing a guidance for orthopedic surgeons in the selection of the most appropriate stem for primary THA, contributing to our understanding of cementless stem performance, presenting invaluable insights to further improve patient outcomes in THA surgery.
Identifiants
pubmed: 38112778
doi: 10.1007/s00402-023-05144-x
pii: 10.1007/s00402-023-05144-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Long H, Liu Q, Yin H, Wang K, Diao N, Zhang Y et al (2022) Prevalence trends of site-specific osteoarthritis from 1990 to 2019: findings from the global burden of disease study 2019. Arthritis Rheumatol luglio 74(7):1172–1183
doi: 10.1002/art.42089
Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. The Lancet Ottobre 370(9597):1508–1519
doi: 10.1016/S0140-6736(07)60457-7
Duwelius PJ, Southgate RD, Crutcher JP, Rollier GM, Li HF, Sypher KS et al (2023) Registry data show complication rates and cost in revision hip arthroplasty. J Arthroplasty luglio 38(7):S29-33
doi: 10.1016/j.arth.2023.04.050
Registro Italiano ArtroProtesi (RIAP), Report Annuale 2021. https://riap.iss.it/riap/it/attivita/report/2022/10/27/report-annuale-riap-2021/ . Accessed 5 May 2023
Registro Regionale di Implantologia Protesica Ortopedica (RIPO), dati complessivi interventi di protesi d’anca, di ginocchio e di spalla in Emilia Romagna, Rendiconto Attività 2000–2019. https://ripo.cineca.it/authzssl/index.htm . Accessed 3 May 2023.
Shichman I, Kurapatti M, Roof M, Christensen TH, Rozell JC, Schwarzkopf R (2022) Impact of Indication for Revision THA on Resource Utilization. J Arthroplasty Dicembre 37(12):2333–2339
doi: 10.1016/j.arth.2022.06.007
Scott CEH, Turnbull GS, Powell-Bowns MFR, MacDonald DJ, Breusch SJ (2018) Activity levels and return to work after revision total hip and knee arthroplasty in patients under 65 years of age. Bone Jt J Agosto 100-B(8):1043–1053
doi: 10.1302/0301-620X.100B8.BJJ-2017-1557.R2
Kelmer G, Stone AH, Turcotte J, King PJ (2021) Reasons for revision: primary total hip arthroplasty mechanisms of failure. J Am Acad Orthop Surg 29(2):78–87
doi: 10.5435/JAAOS-D-19-00860
pubmed: 32404682
Kummerant J, Wirries N, Derksen A, Budde S, Windhagen H, Floerkemeier T (2020) The etiology of revision total hip arthroplasty: current trends in a retrospective survey of 3450 cases. Arch Orthop Trauma Surg 140(9):1265–1273
doi: 10.1007/s00402-020-03514-3
pubmed: 32607655
Charnley J (1961) Arthroplasty of the hip. A new operation. Lancet 1(7187):1129–1132. https://doi.org/10.1016/s0140-6736(61)92063-3
doi: 10.1016/s0140-6736(61)92063-3
pubmed: 15898154
Berry DJ (2000) Evolution of uncemented femoral component design. In: Pellicci PM, Tria AJ, Garvin KL (eds) Orthopaedic knowledge update: hip and knee reconstruction 2, 2nd edn. American Academy of Orthopaedic Surgeons, Rosemont, pp 117–127
Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop 235:148–165
doi: 10.1097/00003086-198810000-00015
Giardina F, Castagnini F, Stea S, Bordini B, Montalti M, Toni A (2018) Short stems versus conventional stems in cementless total hip arthroplasty: a long-term registry study. J Arthroplasty 33(6):1794–1799
doi: 10.1016/j.arth.2018.01.005
pubmed: 29395723
Maloney WJ, Jasty M, Rosenberg A, Harris WH (1990) Bone lysis in well-fixed cemented femoral components. J Bone Jt Surg Br 72(6):966–970. https://doi.org/10.1302/0301-620X.72B6.2246299
doi: 10.1302/0301-620X.72B6.2246299
Jones LC, Hungerford DS (1987) Cement disease. Clin Orthop Relat Res 225:192–206
doi: 10.1097/00003086-198712000-00016
Meding JB, Ritter MA, Keating ME, Berend ME (2015) Twenty-year followup of an uncemented stem in primary THA. Clin Orthop febbraio 473(2):543–548
doi: 10.1007/s11999-014-3763-y
Huo MH, Dumont GD, Knight JR, Mont MA (2011) What’s new in total hip arthroplasty. J Bone Joint Surg Am 93(20):1944–1950. https://doi.org/10.2106/JBJS.K.00656
doi: 10.2106/JBJS.K.00656
pubmed: 22012533
Khanuja HS, Vakil JJ, Goddard MS, Mont MA (2011) Cementless femoral fixation in total hip arthroplasty. J Bone Jt Surg 93(5):500–509
doi: 10.2106/JBJS.J.00774
Lord GA, Hardy JR, Kummer FJ (1979) An uncemented total hip replacement: experimental study and review of 300 madreporique arthroplasties. Clin Orthop Relat Res 141:2–16
Report_RIAP_2021–2.pdf. https://riap.iss.it/riap/it/ . Accessed 25 Apr 2023
Swedish register Annual Report 2021.pdf. https://sar.registercentrum.se/about-the-register/annual-reports/p/SJW4-ZGyo . Accessed 25 Apr 2023
NJR 19th Annual Report 2022.pdf. https://www.hqip.org.uk/wp-content/uploads/2022/11/NJR-19th-Annual-Report-2022.pdf . Accessed 25 Apr 2023
Bourne RB, Rorabeck CH, Burkart BC, Kirk PG (1994) Ingrowth surfaces. Plasma spray coating to titanium alloy hip replacements. Clin Orthop Relat Res 298:37–46
doi: 10.1097/00003086-199401000-00007
Pilliar RM (1983) Powder metal-made orthopedic implants with porous surface for fixation by tissue ingrowth. Clin Orthop Relat Res 176:42–51
doi: 10.1097/00003086-198306000-00007
Callaghan JJ (1993) The clinical results and basic science of total hip arthroplasty with porous-coated prostheses. J Bone Joint Surg Am 75(2):299–310. https://doi.org/10.2106/00004623-199302000-00020
doi: 10.2106/00004623-199302000-00020
pubmed: 8423192
Cook SD, Thomas KA, Kay JF, Jarcho M (1988) Hydroxyapatite-coated titanium for orthopedic implant applications. Clin Orthop Relat Res 232:225–243
doi: 10.1097/00003086-198807000-00030
Søballe K, Hansen ES, Brockstedt-Rasmussen H, Bünger C (1993) Hydroxyapatite coating converts fibrous tissue to bone around loaded implants. J Bone Joint Surg Br 75:270–278
doi: 10.1302/0301-620X.75B2.8444949
pubmed: 8444949
Søballe K, Overgaard S (1996) The current status of hydroxyapatite coating of prostheses. J Bone Joint Surg Br 78:689–691
doi: 10.1302/0301-620X.78B5.0780689
pubmed: 8836049
Zweymüller KA, Lintner FK, Semlitsch MF (1988) Biologic fixation of a press-fit titanium hip joint endoprosthesis. Clin Orthop Relat Res 235:195–206
doi: 10.1097/00003086-198810000-00019
Bingham JS, Hart A, Abdel MP (2017) The evolvement of cementless stems: risks and rewards. Semin Arthroplasty 28(4):215–223
doi: 10.1053/j.sart.2018.02.004
Kheir MM, Drayer NJ, Chen AF (2020) An update on cementless femoral fixation in total hip arthroplasty. J Bone Joint Surg Am 102(18):1646–1661. https://doi.org/10.2106/JBJS.19.01397
doi: 10.2106/JBJS.19.01397
pubmed: 32740265
Liu Y, Li C, Cao Z, Wang X, Wen J, Ping H, Kong X, Chai W (2023) Undetected intraoperative periprosthetic femoral fractures in patients undergoing primary total hip arthroplasty: a retrospective case series and literature review. Orthop Surg 15(3):758–765. https://doi.org/10.1111/os.13646 . (Epub 2023 Jan 17)
doi: 10.1111/os.13646
pubmed: 36647808
pmcid: 9977600
Radaelli M, Buchalter DB, Mont MA, Schwarzkopf R, Hepinstall MS (2023) A new classification system for cementless femoral stems in total hip arthroplasty. J Arthroplasty 38(3):502–510. https://doi.org/10.1016/j.arth.2022.09.014 . (Epub 2022 Sep 17)
doi: 10.1016/j.arth.2022.09.014
pubmed: 36122690
Burt CF, Garvin KL, Otterberg ET, Jardon OM (1998) A femoral component inserted without cement in total hip arthroplasty. A study of the Tri-Lock component with an average ten-year duration of follow-up. J Bone Joint Surg Am 80(7):952–960. https://doi.org/10.2106/00004623-199807000-00003
doi: 10.2106/00004623-199807000-00003
pubmed: 9697999
Sharkey PF, Albert TJ, Hume EL, Rothman RH (1990) Initial stability of a collarless wedge-shaped prosthesis in the femoral canal. Semin Arthroplasty 1(1):87–90
pubmed: 10149562
Hozack WJ, Booth RE Jr (1990) Clinical and radiographic results with the Trilock femoral component–a wedge-fit porous ingrowth stem design. Semin Arthroplasty 1(1):64–69
pubmed: 10149559
Vresilovic EJ, Hozack WJ, Rothman RH (1994) Radiographic assessment of cementless femoral components. Correlation with intraoperative mechanical stability. J Arthroplasty 9(2):137–141. https://doi.org/10.1016/0883-5403(94)90062-0
doi: 10.1016/0883-5403(94)90062-0
pubmed: 8014644
Müller LA, Wenger N, Schramm M, Hohmann D, Forst R, Carl HD (2010) Seventeen-year survival of the cementless CLS Spotorno stem. Arch Orthop Trauma Surg 130(2):269–275. https://doi.org/10.1007/s00402-009-0969-7
doi: 10.1007/s00402-009-0969-7
pubmed: 19760225
Lombardi AV Jr, Berend KR, Mallory TH, Skeels MD, Adams JB (2009) Survivorship of 2000 tapered titanium porous plasma-sprayed femoral components. Clin Orthop Relat Res 467(1):146–154. https://doi.org/10.1007/s11999-008-0568-x . (Epub 2008 Oct 31)
doi: 10.1007/s11999-008-0568-x
pubmed: 18975042
Bourne RB, Rorabeck CH, Patterson JJ, Guerin J (2001) Tapered titanium cementless total hip replacements: a 10- to 13-year followup study. Clin Orthop Relat Res 393:112–120
doi: 10.1097/00003086-200112000-00013
Wagner H, Wagner M (2000) Cone prosthesis for the hip joint. Arch Orthop Trauma Surg 120(1–2):88–95. https://doi.org/10.1007/pl00021223
doi: 10.1007/pl00021223
pubmed: 10653112
Park MS, Choi BW, Kim SJ, Park JH (2003) Plasma spray-coated Ti femoral component for cementless total hip arthroplasty. J Arthroplasty 18(5):626–630. https://doi.org/10.1016/s0883-5403(03)00203-1
doi: 10.1016/s0883-5403(03)00203-1
pubmed: 12934216
Ellison B, Berend KR, Lombardi AV Jr, Mallory TH (2006) Tapered titanium porous plasma-sprayed femoral component in patients aged 40 years and younger. J Arthroplasty 21(6 Suppl 2):32–37. https://doi.org/10.1016/j.arth.2006.03.008
doi: 10.1016/j.arth.2006.03.008
pubmed: 16950059
Mont MA, Yoon TR, Krackow KA, Hungerford DS (1999) Clinical experience with a proximally porous-coated second-generation cementless total hip prosthesis: minimum 5-year follow-up. J Arthroplasty 14(8):930–939. https://doi.org/10.1016/s0883-5403(99)90006-2
doi: 10.1016/s0883-5403(99)90006-2
pubmed: 10614883
Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop Relat Res 235:148–165
doi: 10.1097/00003086-198810000-00015
Callaghan JJ, Fulghum CS, Glisson RR, Stranne SK (1992) The effect of femoral stem geometry on interface motion in uncemented porous-coated total hip prostheses. Comparison of straight-stem and curved-stem designs. J Bone Joint Surg Am 74(6):839–848
doi: 10.2106/00004623-199274060-00005
pubmed: 1634574
Xenos JS, Callaghan JJ, Heekin RD, Hopkinson WJ, Savory CG, Moore MS (1999) The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum of ten years of follow-up. J Bone Joint Surg Am 81(1):74–82. https://doi.org/10.2106/00004623-199901000-00011
doi: 10.2106/00004623-199901000-00011
pubmed: 9973057
Butler JB, Lansky D, Duwelius PJ (2005) Prospective evaluation of total hip arthroplasty with a cementless, anatomically designed, porous-coated femoral implant: mean 11-year follow-up. J Arthroplasty 20(6):709–716. https://doi.org/10.1016/j.arth.2004.11.011
doi: 10.1016/j.arth.2004.11.011
pubmed: 16139706
Zhang Z, Zhuo Q, Chai W, Ni M, Li H, Chen J (2016) Clinical characteristics and risk factors of periprosthetic femoral fractures associated with hip arthroplasty: a retrospective study. Medicine (Baltimore) 95(35):e4751. https://doi.org/10.1097/MD.0000000000004751
doi: 10.1097/MD.0000000000004751
pubmed: 27583925
Di Martino A, Rossomando V, Brunello M, D’Agostino C, Pederiva D, Frugiuele J, Pilla F, Faldini C (2023) How to perform correct templating in total hip replacement. Musculoskelet Surg 107(1):19–28. https://doi.org/10.1007/s12306-023-00772-3 . (Epub 2023 Jan 11; Review)
doi: 10.1007/s12306-023-00772-3
pubmed: 36630067
Siddiqi A, Springer BD, Chen AF, Piuzzi NS (2021) Diagnosis and management of intraoperative fractures in primary total hip arthroplasty. J Am Acad Orthop Surg 29(10):e497–e512. https://doi.org/10.5435/JAAOS-D-20-00818
doi: 10.5435/JAAOS-D-20-00818
pubmed: 33475301
Di Martino A, Castagnini F, Stefanini N, Bordini B, Geraci G, Pilla F, Traina F, Faldini C (2021) Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study. J Orthop Traumatol 22(1):29. https://doi.org/10.1186/s10195-021-00590-y
doi: 10.1186/s10195-021-00590-y
pubmed: 34275012
pmcid: 8286209
Di Martino A, Coppola MAR, Bordini B, Stefanini N, Geraci G, Pilla F, Traina F, Faldini C (2021) Clinical and radiological outcomes of total hip arthroplasty in patients affected by Paget’s disease: a combined registry and single-institution retrospective observational study. J Orthop Traumatol 22(1):13. https://doi.org/10.1186/s10195-021-00574-y
doi: 10.1186/s10195-021-00574-y
pubmed: 33733386
pmcid: 7969678
Zweymüller K, Semlitsch M (1982) Concept and material properties of a cementless hip prosthesis system with Al
doi: 10.1007/BF00381662
pubmed: 7159194
Grübl A, Chiari C, Giurea A, Gruber M, Kaider A, Marker M, Zehetgruber H, Gottsauner-Wolf F (2006) Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88(10):2210–2215. https://doi.org/10.2106/JBJS.E.00810
doi: 10.2106/JBJS.E.00810
pubmed: 17015598
Suckel A, Geiger F, Kinzl L, Wulker N, Garbrecht M (2009) Long-term results for the uncemented Zweymuller/Alloclassic hip endoprosthesis. A 15-year minimum follow-up of 320 hip operations. J Arthroplasty 24(6):846–853. https://doi.org/10.1016/j.arth.2008.03.021 . (Epub 2008 Sep 11)
doi: 10.1016/j.arth.2008.03.021
pubmed: 18789635