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Der zementierte MS-30-Schaft

Ergebnisse einer Multi-surgeon-Serie von 333 konsekutiven Fällen

The cemented MS-30 stem

A multi-surgeon series of 333 consecutive cases

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Zusammenfassung

Hintergrund

Bis jetzt existiert lediglich eine publizierte Langzeitstudie (peer reviewed) aus der Inauguratoren-Klinik für den zementierten MS-30-Schaft.

Material und Methoden

In dieser retrospektiven „Multi-surgeon-Studie“ wurden die ersten 333 konsekutiven MS-30-Schäfte nachuntersucht. Alle Patienten mit 5–11 Jahren Follow-up wurden klinisch und radiologisch evaluiert. Zum Zeitpunkt der Implantation wurden die Kriterien der modernen Zementiertechniken nicht konsequent umgesetzt. Zur klinischen Evaluation dienten der Harris-Hip-Score (HHS) sowie der Score nach Merle d‘Aubigné u. Postel. In der radiologischen Auswertung wurden die Qualität des Zementmantels in 2 Ebenen, Prothesennachsinken, Lockerungszeichen und Osteolysen beurteilt.

Ergebnisse

Zum Zeitpunkt der Nachuntersuchung waren 12 Schäfte revidiert – 3 aufgrund aseptischer Lockerung, 6 wegen Infektionen, 1 nach periprothetischer Fraktur und 2 aufgrund rezidivierender Luxationen. Die Überlebensrate nach 10 Jahren unabhängig vom Revisionsgrund lag bei 96,1%, für aseptische Lockerungen bei 99,0%. Der mediane HHS lag bei 80 (26–100) Punkten. Die radiologische Analyse ergab in fast zwei Drittel der Fälle einen dünnen Zementmantel (<2 mm), der hauptsächlich in den lateralen Aufnahmen (Gruen-Zone 8/9) manifest wurde. Ein Drittel der Prothesen zeigten radiologische Risikozeichen für eine spätere Lockerung, die eng mit der initialen Qualität des Zementmantels korrelierten.

Schlussfolgerung

Die mittelfristigen Ergebnisse mit dem MS-30-Schaft sind ermutigend und sollten mit einer modernen Zementiertechnik weiter verbessert werden können.

Abstract

Introduction

So far there is only one peer-reviewed long-term publication from the inventors’ clinic for the MS-30 stem.

Material and methods

In a retrospective study we followed the first 333 consecutive MS-30 stems. All patients with 5- to 11-year follow-up were clinically and radiographically evaluated. At the time of implantation the criteria of modern cementing techniques were not implemented. Clinical evaluation was done using the scores of Harris and Merle d’Aubigné and Postel. Radiographic evaluation included quality of the cement mantle (true lateral radiographs taken under fluoroscopy), stem subsidence, loosening signs, and the risk for pending failure.

Results

At follow-up 12 hips had undergone femoral revision: 3 for aseptic loosening, 6 for infection, 1 for periprosthetic fracture, and 2 for recurrent dislocation. The overall survival for all reasons at 10 years was 96.1%; survival with aseptic loosening as an end point was 99.0%. The median Harris Hip Score at follow-up was 80 (26–100) points. Radiological evaluation revealed a thin cement mantle (<2 mm) in approximately 2/3, predominantly on the lateral views (Gruen zones 8/9). One-third of all reviewed prostheses were considered at risk for pending failure, which strongly correlated with the initial quality of the cement mantle.

Conclusion

Midterm results with the MS-30 stem are encouraging and an even better long-term outcome can be expected with a better cement technique.

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Authors and Affiliations

  1. Institut für medizinische Biometrie und Informatik, Universität, Heidelberg

    M. Pritsch

  2. Department of Orthopaedic Surgery, University, Edinburgh, England

    S. J. Breusch

  3. Stiftung Orthopädische Universitätsklinik, Schlierbacher Landstraße 200a, 69118, Heidelberg

    M. Clauss, T. Reitzel, U. J Schlegel, R. G. Bitsch, V. Ewerbeck, H. Mau & S. J. Breusch

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  1. M. Clauss
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  2. T. Reitzel
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  3. M. Pritsch
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Clauss, M., Reitzel, T., Pritsch, M. et al. Der zementierte MS-30-Schaft. Orthopäde 35, 776–783 (2006). https://doi.org/10.1007/s00132-006-0956-4

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