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Primary total hip arthroplasty with a fully porous-coated uncemented stem: up to twenty-eight years. Retrospective cohort study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The use of cementless prosthesis has increased in the last 30 years with the aim of improving the long-term results of total hip arthroplasties in young and active patients. Encouraging results have recently been reported for cementless titanium and cobalt chromium stems. However, there are few studies with long-term follow-up, and the majority have analysed several models of uncemented stems due to their modifications over the years. Therefore, the aim was to assess the long-term survival rate of the Mittelmeier Mark III or Autophor 900-S stem.

Methods

A retrospective cohort study of both gender patients under 70 years old with at least one implanted Mittelmeier Mark III uncemented stem was performed. Survival rate was defined as the proportion of stems that did not need a surgical revision from any cause. Clinical status was evaluated using the Merle d'Aubigne scale modified by Matta (excellent/good/fair/poor).

Results

Between 1990 and 1999, 73 stems were implanted. The mean (SD) age at surgical time was 49.3 (9.9) years, and the median (range) of follow-up was 22 (1–28) years. The overall survival rate was 93% (68/73, 95%CI: 85–97%). The stem revisions were due to stem breakage (n = 2), to aseptic loosening (n = 2) and to septic loosening (n = 1). Clinical results were: excellent 84%, good 15% and fair 1.5%.

Conclusions

The Mittelmeier Mark III stem had an excellent survival rate with a stable long-term fixation and excellent clinical outcomes.

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Acknowledgements

Dr. B. Sahun-Mairal is a PhD candidate in the Universitat de Barcelona, Spain.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Hospital Universitari de Bellvitge, Hospitalet de Llobregat, C/ Feixa Llarga S/N 08907 L’Hospitalet de Llobregat, Barcelona, Spain

    B. Sahun-Mairal, J. L. Agullo-Ferre, D. Rodriguez-Perez, I. Garreta-Catala, C. Tramunt-Monsonet, S. Videla & A. Coscujuela-Maña

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  1. B. Sahun-Mairal
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  2. J. L. Agullo-Ferre
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  3. D. Rodriguez-Perez
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  5. C. Tramunt-Monsonet
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  6. S. Videla
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  7. A. Coscujuela-Maña
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Contributions

BS-M, IG-C and JLA-F designed and wrote the study protocol, and all authors approved the final version of the protocol; BS-M, IG-C, DR-P and CT-M collected the study data; IG-C and SBS-M managed the data and performed the statistical analysis; and BS-M, IG-C and SV wrote the draught of the manuscript and all of the authors have read and approved the final manuscript. Therefore, all authors abovementioned provide substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND drafting the work or revising it critically for important intellectual content; AND final approval of the version to be published; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to B. Sahun-Mairal.

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Sahun-Mairal, B., Agullo-Ferre, J.L., Rodriguez-Perez, D. et al. Primary total hip arthroplasty with a fully porous-coated uncemented stem: up to twenty-eight years. Retrospective cohort study. Eur J Orthop Surg Traumatol 32, 91–97 (2022). https://doi.org/10.1007/s00590-021-02940-2

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  • DOI: https://doi.org/10.1007/s00590-021-02940-2

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