Early Migration Characteristics of a Hydroxyapatite-coated Femoral Stem: an RSA Study

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2009 Dec 17

PMID 20012862

Citations 55

Authors

David Campbell

Graham Mercer

Kjell G Nilsson

Vanessa Wells

John R Field

Stuart A Callary

Affiliations

Soon will be listed here.

Abstract

Measurement of early stem subsidence can be used to predict the likelihood of long-term femoral component loosening and clinical failure. Data that examines the early migration pattern of clinically proven stems will provide clinicians with useful baseline data with which to compare new stem designs. This study was performed to evaluate the early migration pattern of a hydroxyapatite-coated press-fit femoral component that has been in use for over ten years. We enrolled 30 patients who underwent THA for osteoarthritis. The median age was 70 years (range, 55-80 years). Patients were clinically assessed using the Harris hip score. Radiostereometric analysis was used to evaluate stem migration at three to four days, six months, one year and two years. We observed a mean subsidence of 0.73 mm at six months, 0.62 mm at one year and 0.58 mm at two years and a mean retroversion of 1.82° at six months, 1.90° at one year and 1.59° at two years. This data suggests that subsidence is confined to the first six months after which there was no further subsidence. The results from this study can be compared with those from novel cementless stem designs to help predict the long-term outcome one may expect from new cementless stem designs.

Citing Articles

Stem subsidence in total hip arthroplasty: retrospective investigation of a short stem using a simple measurement approach.

Horst N, Theil C, Gosheger G, Kalisch T, Moellenbeck B Arch Orthop Trauma Surg. 2024; 145(1):40.

PMID: 39680151 PMC: 11649837. DOI: 10.1007/s00402-024-05642-6.

Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA.

Kaji E, Grove A, Lehtonen E, Mulford K, Rouzrokh P, Hannon C Arthroplast Today. 2024; 30:101553.

PMID: 39619703 PMC: 11605327. DOI: 10.1016/j.artd.2024.101553.

Subsidence of the Corail stem in total hip arthroplasty: no influence of bony contact.

Migliorini F, Maffulli N, Pilone M, Kammer D, Hofmann U, Nobili A J Orthop Traumatol. 2024; 25(1):53.

PMID: 39522073 PMC: 11551085. DOI: 10.1186/s10195-024-00794-y.

Comparison of 5-year cup and stem migration between ceramic-on-ceramic and ceramic-on-polyethylene bearing in press-fit total hip arthroplasty: a randomised controlled trial using radiostereometric analysis.

Klaassen A, van Loon J, Willigenburg N, Koster L, Kaptein B, van der Hulst V Hip Int. 2024; 34(6):701-716.

PMID: 39160668 PMC: 11629593. DOI: 10.1177/11207000241265653.

Does Lack of Initial Collar-Calcar Contact Influence Performance of Collared Cementless Femoral Stems?.

Weiner T, Woelfle C, Xu W, Yim D, Shah R, Cooper H Arthroplast Today. 2024; 27:101432.

PMID: 38882465 PMC: 11180310. DOI: 10.1016/j.artd.2024.101432.

References

Karrholm J, Herberts P, Hultmark P, Malchau H, Nivbrant B, Thanner J . Radiostereometry of hip prostheses. Review of methodology and clinical results. Clin Orthop Relat Res. 1997; (344):94-110. View

Bragdon C, Greene M, Freiberg A, Harris W, Malchau H . Radiostereometric analysis comparison of wear of highly cross-linked polyethylene against 36- vs 28-mm femoral heads. J Arthroplasty. 2007; 22(6 Suppl 2):125-9. DOI: 10.1016/j.arth.2007.03.009. View

Krismer M, Biedermann R, Stockl B, Fischer M, Bauer R, Haid C . 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 Joint Surg Br. 1999; 81(2):273-80. DOI: 10.1302/0301-620x.81b2.8840. View

Mazoochian F, Schrimpf F, Kircher J, Mayer W, Hauptmann S, Fottner A . Proximal loading of the femur leads to low subsidence rates: first clinical results of the CR-stem. Arch Orthop Trauma Surg. 2007; 127(6):397-401. DOI: 10.1007/s00402-007-0384-x. View

Makela K, Eskelinen A, Pulkkinen P, Paavolainen P, Remes V . Total hip arthroplasty for primary osteoarthritis in patients fifty-five years of age or older. An analysis of the Finnish arthroplasty registry. J Bone Joint Surg Am. 2008; 90(10):2160-70. DOI: 10.2106/JBJS.G.00870. View

Strom H, Mallmin H, Milbrink J, Petren-Mallmin M, Nivbrant B, Kolstad K . The cone hip stem: a prospective study of 13 patients followed for 5 years with RSA. Acta Orthop Scand. 2003; 74(5):525-30. DOI: 10.1080/00016470310017901 . View

Karrholm J, Borssen B, Lowenhielm G, Snorrason F . Does early micromotion of femoral stem prostheses matter? 4-7-year stereoradiographic follow-up of 84 cemented prostheses. J Bone Joint Surg Br. 1994; 76(6):912-7. View

Onsten I, Berzins A, Shott S, Sumner D . Accuracy and precision of radiostereometric analysis in the measurement of THR femoral component translations: human and canine in vitro models. J Orthop Res. 2002; 19(6):1162-7. DOI: 10.1016/S0736-0266(01)00039-0. View

Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S . The effect of early weight bearing on migration pattern of the uncemented CLS stem in total hip arthroplasty. J Arthroplasty. 2007; 22(8):1122-9. DOI: 10.1016/j.arth.2006.11.015. View

10.

Stefansdottir A, Franzen H, Johnsson R, Ornstein E, Sundberg M . Movement pattern of the Exeter femoral stem; a radiostereometric analysis of 22 primary hip arthroplasties followed for 5 years. Acta Orthop Scand. 2004; 75(4):408-14. DOI: 10.1080/00016470410001169-1. View

11.

Hallan G, Lie S, Furnes O, Engesaeter L, Vollset S, Havelin L . Medium- and long-term performance of 11,516 uncemented primary femoral stems from the Norwegian arthroplasty register. J Bone Joint Surg Br. 2007; 89(12):1574-80. DOI: 10.1302/0301-620X.89B12.18969. View

12.

Reikeras O, Gunderson R . Excellent results of HA coating on a grit-blasted stem: 245 patients followed for 8-12 years. Acta Orthop Scand. 2003; 74(2):140-5. DOI: 10.1080/00016470310013851 . View

13.

Gheduzzi S, Miles A . A review of pre-clinical testing of femoral stem subsidence and comparison with clinical data. Proc Inst Mech Eng H. 2007; 221(1):39-46. DOI: 10.1243/09544119JEIM129. View

14.

Strom H, Nilsson O, Milbrink J, Mallmin H, Larsson S . Early migration pattern of the uncemented CLS stem in total hip arthroplasties. Clin Orthop Relat Res. 2006; 454:127-32. DOI: 10.1097/01.blo.0000238785.98606.9d. View

15.

Froimson M, Garino J, Machenaud A, Vidalain J . Minimum 10-year results of a tapered, titanium, hydroxyapatite-coated hip stem: an independent review. J Arthroplasty. 2007; 22(1):1-7. DOI: 10.1016/j.arth.2006.03.003. View

16.

Malchau H, Karrholm J, Wang Y, Herberts P . Accuracy of migration analysis in hip arthroplasty. Digitized and conventional radiography, compared to radiostereometry in 51 patients. Acta Orthop Scand. 1995; 66(5):418-24. DOI: 10.3109/17453679508995578. View

17.

Grant P, Aamodt A, Falch J, Nordsletten L . Differences in stability and bone remodeling between a customized uncemented hydroxyapatite coated and a standard cemented femoral stem A randomized study with use of radiostereometry and bone densitometry. J Orthop Res. 2005; 23(6):1280-5. DOI: 10.1016/j.orthres.2005.03.016.1100230607. View

18.

Valstar E, Gill R, Ryd L, Flivik G, Borlin N, Karrholm J . Guidelines for standardization of radiostereometry (RSA) of implants. Acta Orthop. 2005; 76(4):563-72. DOI: 10.1080/17453670510041574. View

19.

Kurtz S, Ong K, Lau E, Mowat F, Halpern M . Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007; 89(4):780-5. DOI: 10.2106/JBJS.F.00222. View

20.

Lubbeke A, Katz J, Perneger T, Hoffmeyer P . Primary and revision hip arthroplasty: 5-year outcomes and influence of age and comorbidity. J Rheumatol. 2006; 34(2):394-400. View