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Outcome of hybrid stem fixation in osteoporotic female patients. A minimum five-year follow-up study

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Abstract

In osteoporotic patients cemented stems are usually used to achieve a good primary stability. However, when patients are obese or active the long-term survival of cemented prostheses is questioned. In these patients, a partially-cemented stem with a hybrid fixation could be advantageous. A hybrid stem was retrospectively evaluated at a minimum follow-up of 60 months (mean, 75 months) in 58 osteoporotic women: seventeen with a body mass index (BMI) >30 (obese), 41 with a BMI between 25 and 29.9 (overweight), and an UCLA score for activity level >6. At the latest follow up, the Harris hip score improved from 33.5 points preoperatively to 81.6 points, and the WOMAC score improved significantly. Three stems (4.9%) had an asymptomatic subsidence of less than 2.5 mm; no stem was revised. These results support the use of partially-cemented stems in heavy or active osteoporotic women.

Résumé

Chez les patients présentant une ostéoporose une pièce fémorale cimentée est habituellement utilisée de façon à avoir une bonne stabilité. Cependant chez certains patients obèses et très actifs la courbe de survie peut, dans ce cas, être altérée. Ces patients ont eu la possibilité d’être opérés avec une prothèse partiellement cimentée, cette fixation hybride pouvant être avantageuse. Matériel et méthode: cette prothèse fémorale hybride a été évaluée de façon rétrospective avec un minimum de suivi de 60 mois (en moyenne 75 mois) chez 58 patients ostéoporotiques,17 femmes présentant un BMI > 30 (obèses), 41 avec un BMI entre 25 et 29,9 (surpoids) et un score UCLA supérieur à 6. Résultats: au dernier suivi le score de Harris a montré une amélioration de 33,5 points en préopératoire à 81,6 points, le score de Womac s’est également amélioré de façon significative. Trois pièces fémorales ont présenté une migration (4,9%) de moins de 2,5 millimètres, aucune révision fémorale n’a été réalisée. En conclusion, ces résultats permettent de penser qu’une prothèse partiellement cimentée hybride est indiquée chez ces patients obèses actifs et présentant une ostéoporose notamment chez la femme.

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Authors and Affiliations

  1. 1st Department of Orthopaedic Surgery, Laboratory of Medical Technology (LTM), Istituti Ortopedici Rizzoli, Via G. Pupilli 1, 40136, Bologna, Italy

    Francesco Traina, Enrico Tassinari, Federico Pilla, Marcello De Fine, Federico Biondi, Luca Cristofolini & Aldo Toni

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  1. Francesco Traina
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  2. Enrico Tassinari
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  3. Federico Pilla
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  4. Marcello De Fine
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  5. Federico Biondi
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  6. Luca Cristofolini
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  7. Aldo Toni
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Correspondence to Francesco Traina.

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Traina, F., Tassinari, E., Pilla, F. et al. Outcome of hybrid stem fixation in osteoporotic female patients. A minimum five-year follow-up study. International Orthopaedics (SICOT) 33, 1489–1494 (2009). https://doi.org/10.1007/s00264-008-0645-5

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  • DOI: https://doi.org/10.1007/s00264-008-0645-5

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