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Comparison between straight- and curved-stem Müller femoral prostheses

5- to 10-year results of 545 total hip replacements

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Summary

Between 1977 and 1982, 545 cemented femoral prostheses were implanted, in combination with a noncoated cementless polyethylene acetabular component (RM cup). Three hundred and eighty-one straight-stem and 76 curved-stem Miller femoral components were implanted, as well as 88 collared components with a 130-mm stem and a 130° neck-shaft angle, derived from a long-stem steel prosthesis. Survivorship analysis of revisions for aseptic loosening at 10 years revealed 97% straight-stem survival, 91.6% curved-stem survival, and 88.3% 130° stem survival. “Survival” curves were also constructed for radiological loosening, and the survival rates (patients without radiological evidence of loosening) were 69.8%, 78.8%, and 63.1% respectively at 10 years. The 130° collared stem was associated with significantly less acetabular loosening than the other prostheses. This resulted in less calcar resorption, but there was a higher rate of stem loosening. Acetabular loosening and associated wear products appear to be responsible for calcar resorption, and stress shielding of the calcar appears to be of minor importance in the pathogenesis of aseptic stem loosening. Better cementing techniques have improved survivorship of the curved-stem prosthesis, and early fears of high rates of radiological loosening with the straight stem have not been substantiated.

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References

  1. Arcq M (1973) Die periarticuldren Ossificationen: eine Komplikation der Totalprothese des Hüftgelenkes. Arch Orthop Unfallchir 77:108

    Google Scholar 

  2. Beckenbaugh RD, Ilstrup DM (1978) Total hip arthroplasty. A review of three hundred and thirty-three cases with longterm follow-up. J Bone Joint Surg [Am] 60:306–313

    Google Scholar 

  3. Carlsson AS, Gentz C-F (1980) Mechanical loosening of the femoral head prosthesis in the Charnley total hip arthroplasty. Clin Orthop 147:262–270

    Google Scholar 

  4. Charnley J (1979) Low-friction arthroplasty of the hip. Theory and practice. Springer, Berlin Heidelberg New York

    Google Scholar 

  5. Cotterill P, Hunter GA, Tile M (1982) A radiographic analysis of 166 Charnley-Müller total hip arthroplasties. Clin Orthop 163:120–126

    Google Scholar 

  6. Dobbs SH (1980) Survivorship of total hip replacements. J Bone Joint Surg [Br] 62:168–173

    Google Scholar 

  7. Dunn AW, Hamilton CR (1986) Müller curved stem total hip arthroplasty: long-term follow-up of 185 consecutive cases. South Med J 79:698–701

    Google Scholar 

  8. Eyb R (1987) Die unterschiedlichen Veränderungen am Calcar femoris bei zementierten und zementfreien Hüft-Endoprothesen. Aktuel Probl Chir Orthop 31:196–200

    Google Scholar 

  9. Goodman SB, Schatzker J (1987) Intermediate results of a straight stem prosthesis in primary hip arthroplasty. Clin Orthop 217:111–122

    Google Scholar 

  10. Goldring SR, Schiller AL, Roelke M, Rourke CM, O'Neill DA, Harris WH (1983) The synovial-like membrane at the bone-cement interface in loose total hip replacements and its proposed role in bone lysis. J Bone Joint Surg [Am] 65:575–584

    Google Scholar 

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

    Google Scholar 

  12. Harris WH (1984) Advances in total hip arthroplasty. The metal-backed acetabular component. Clin Orthop 183:4–12

    Google Scholar 

  13. Herren T, Remagen W, Schenk R (1987) Histologie der Implantat-Knochengrenze bei zementierten und nichtzementierten Endoprothesen. Orthopade 16:239–251

    Google Scholar 

  14. Hiertonn C, Blomgren G, Lindgren V (1983) Factors associated with calcar resorption in cemented total hip prostheses. Acta Orthop Scand 54:584

    Google Scholar 

  15. Johnston RC, Crowinshield RD (1983) Roentgenographic results of total hip arthroplasty. A ten-year follow-up study. Clin Orthop 181:92–98

    Google Scholar 

  16. Lewis JL, Askew MJ, Wixson RL, Kramer GM, Tarr RR (1984) The influence of prosthetic stem stiffness and of a calcar collar on the stresses in the proximal end of the femur with a cemented femoral component. J Bone Joint Surg [Am] 66:280–286

    Google Scholar 

  17. Merle D'Aubigné R (1970) Cotation chiffrée de la fonction de la hanche. Rev Chir Orthop 53:481–486

    Google Scholar 

  18. Mjoberg B (1986) Loosening of the cemented hip prosthesis. The importance of heat injury. Acta Orthop Scand 57:[Suppl] 221

    Google Scholar 

  19. Morscher EW (1987) Current state of cementless fixation of endoprostheses. Schweiz Med Wochenschr 9:27–44

    Google Scholar 

  20. Morscher EW, Schmassmann A (1983) Failures of total hip arthroplasty and probable incidence of revision surgery in the future. Calculations according to a mathematical model based on ten years' experience in total hip arthroplasty. Arch Orthop Trauma Surg 101:137–143

    Google Scholar 

  21. Morscher E, Dick W, Kernen V (1982) Cementless fixation of polyethylene acetabular component in total hip arthroplasty. Arch Orthop Trauma Surg 99:223–230

    Google Scholar 

  22. Oh I, Harris WH (1978) Proximal strain distribution in the loaded femur. An in vitro comparison of the distribution in the intact femur and after insertion of different hip replacement femoral components. J Bone Joint Surg [Am] 60:75–85

    Google Scholar 

  23. Olsson SS, Jernberger A, Tryggö D (1981) Clinical and radiological long-term results after Charnley-Müller total hip replacement. A 5- to 10-year follow-up study with special reference to aseptic loosening. Acta Orthop Scand 52:531–542

    Google Scholar 

  24. Remagen W, Morscher E (1984) Histological results with cement-free implanted joint sockets of polyethylene. Arch Orthop Trauma Surg 103:145–151

    Google Scholar 

  25. Reikeras O (1982) Ten-year follow-up of Müller hip replacements. Acta Orthop Scand 53:919–922

    Google Scholar 

  26. Rubin CT, Lanyon LE (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg [Am] 66:397–404

    Google Scholar 

  27. Salvati EA, Wilson PD, Jolley MN, Vakili F, Aglietti P, Brown GC (1981) A ten-year follow-up study of our first one hundred consecutive Charnley total hip replacements. J Bone Joint Surg [Am] 63:753–767

    Google Scholar 

  28. Sarmiento A, Gruen TA (1985) Radiographic analysis of a low-modulus titanium-alloy femoral total hip component. J Bone Joint Surg [Am] 67:48–56

    Google Scholar 

  29. Sarmiento A, Turner M, Latta LL, Tarr RR (1979) Factors contributing to lysis of the femoral neck in total hip arthroplasty. Clin Orthop 145:208–212

    Google Scholar 

  30. Savino AW, Anderson GB, Andriacchi TP, Hampton S, Galante JO (1982) The influence of femoral thickness and implantation technique on the strength of the bone cement bond. Acta Orthop Scand 53:23–27

    Google Scholar 

  31. Soballe K, Christensen F (1988) Improved cementation in total hip replacement. Arch Orthop Trauma Surg 107:50–53

    Google Scholar 

  32. Stauffer RN (1982) Ten-year follow-up study of total hip replacement. With particular reference to roentgenographic loosening of the components. J Bone Joint Surg [Am] 64:983–990

    Google Scholar 

  33. Sutherland CJ, Wilde AH, Borden LS, Marks KE (1982) A ten-year follow-up of one hundred consecutive Müller curved-stem total hip-replacement arthroplasties. J Bone Joint Surg [Am] 64:970–982

    Google Scholar 

  34. Tarr RR, Clarke IC, Gruen TA, Sarmiento A (1982) Predictions of cement bone failure criteria. Three-dimensional finite element models versus clinical reality of total hip replacement. In: Gallagher RH, Simon BR, Johnson RC, Gross JP (eds) Finite elements in biomechanics. Wiley, Chichester

    Google Scholar 

  35. Wroblewski BM (1986) 15- to 21-year results of the Charnley low-friction arthroplasty. Clin Orthop 211:30–35

    Google Scholar 

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Authors and Affiliations

  1. The Division of Orthopaedic Surgery, Department of Surgery, University of Basel, Switzerland

    J. Wilson-MacDonald & E. Morscher

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  1. J. Wilson-MacDonald
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  2. E. Morscher
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Wilson-MacDonald, J., Morscher, E. Comparison between straight- and curved-stem Müller femoral prostheses. Arch Orthop Trauma Surg 109, 14–20 (1989). https://doi.org/10.1007/BF00441904

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