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Clinical and biological assessment of cemented titanium femoral stems: an 11-year experience

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Abstract

This study prospectively assessed the outcome of 134 cemented titanium stems and serum ion levels. The stems were polished (0.1 μm Ra) with circular cross section. At the end point, only one stem revision was performed for aseptic loosening, and two were planned due to subsidence greater than 5 mm. Non-progressive radiolucencies in zones 1 and 7 were observed in 16 hips at the cement-bone interface without osteolysis. Median serum titanium concentrations were below the detection limit (30 nmol/l) except in patients with failed stems. The overall stem survival rate was 97.7% at nine years, which is comparable to other series of cemented stems. The protective layer of titanium oxide coating the stem and a thick cement mantle may help resist aseptic loosening. In addition, satisfactory monitoring of the stem was reached using titanium serum level determination.

Résumé

Cette étude rapporte le suivi clinique prospectif d’une série de 134 tiges fémorales titane cimentées et l’évolution des taux de titane sérique. Les implants étaient en titane anodisé, lisses (0.1-microm Ra) et de section circulaire. Au recul moyen de 9 ans, le taux de survie était de 97,7%, ce qui est comparable aux autres séries de tiges cimentées. On notait une reprise pour descellement et deux révisions prévisibles pour un enfoncement supérieur à 5 mm. Des liserés non évolutifs étaient observés en zones 1 et 7 pour 16 hanches sans ostéolyse. La médiane du titane sérique était inférieure à la limite de détection (30 nmol/l) à l’exception des 3 échecs où les taux sont étaient nettement plus élevés. La couche protectrice d’oxyde de titane et l’épaisseur du manteau de ciment peuvent expliquer la résistance au descellement aseptique. Le taux de titane sérique semble intéressant pour la surveillance des tiges titanes cimentées.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France

    Patrick Boyer & Philippe Ravaud

  2. Pitié-Salpétrière, Paris, France

    Jean-Yves Lazennec, Marc-Antoine Rousseau & Yves Catonné

  3. Lariboisière, Paris, France

    Joel Poupon

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  1. Patrick Boyer
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  2. Jean-Yves Lazennec
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  3. Joel Poupon
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  4. Marc-Antoine Rousseau
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  5. Philippe Ravaud
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  6. Yves Catonné
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Correspondence to Patrick Boyer.

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Boyer, P., Lazennec, JY., Poupon, J. et al. Clinical and biological assessment of cemented titanium femoral stems: an 11-year experience. International Orthopaedics (SICOT) 33, 1209–1215 (2009). https://doi.org/10.1007/s00264-008-0678-9

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  • DOI: https://doi.org/10.1007/s00264-008-0678-9

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