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Ten-year results of uncemented hip stems for failed intertrochanteric osteotomy

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Abstract

Introduction

Inferior survival of cemented total hip arthroplasty has been reported after previous femoral osteotomy. The purpose of this study was to evaluate the long-term survival of uncemented stems after femoral osteotomy.

Materials and methods

Forty-eight hips in 45 patients had undergone conversion THA for a failed intertrochanteric osteotomy of the hip after a mean of 12 years (2–33 years). Mean time of follow-up was 11 years (5–15 years).

Results

At follow-up, two patients (three hips) had died, and one patient (one hip) was not located. Three patients (three hips) underwent femoral revision—one for infection and two for aseptic loosening of the stem. Survival of the stem was 94% at 10 years, and survival with femoral revision for aseptic loosening as an end point was 96%. The median Harris Hip Score at follow-up was 80 points. Radiolucent lines in Gruen zones 1 and 7 were present in 14 and 18% of hips, respectively. Radiolucencies in other zones were not detected. There was no radiographic evidence of femoral osteolysis, stress-shielding or loosening.

Conclusion

The results with this type of uncemented tapered titanium femoral component after proximal femoral osteotomy are encouraging and compare to those achieved in patients with regular femoral anatomy.

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References

  1. Aldinger PR, Breusch SJ, Lukoschek M, Mau H, Ewerbeck V, Thomsen M (2003) A 10- to 15-year follow-up of the cementless Spotorno stem. J Bone Joint Surg Br 85:209–214

    Article  CAS  PubMed  Google Scholar 

  2. Aldinger PR, Sabo D, Pritsch M, Thomsen M, Mau H, Ewerbeck V, Breusch SJ (2003) Pattern of periprosthetic bone remodeling around stable uncemented tapered hip stems: a prospective 84-month follow-up study and a median 156-month cross-sectional study with DXA. Calcif Tissue Int 73:115–121

    Article  CAS  PubMed  Google Scholar 

  3. Aldinger PR, Thomsen M, Mau H, Ewerbeck V, Breusch SJ (2003) Cementless Spotorno tapered titanium stems: excellent 10–15-year survival in 141 young patients. Acta Orthop Scand 74:253–258

    Article  PubMed  Google Scholar 

  4. Aldinger PR, Thomsen M, Lukoschek M, Mau H, Ewerbeck V, Breusch SJ (2004) Long-term fate of uncemented, threaded acetabular components with smooth surface treatment: minimum 10-year follow-up of two different designs. Arch Orthop Trauma Surg 124:469–475

    Google Scholar 

  5. Ballard WT, Callaghan JJ, Sullivan PM, Johnston RC (1994) The results of improved cementing techniques for total hip arthroplasty in patients less than 50 years old. A 10-year follow-up study. J Bone Joint Surg Am 76:959–964

    Google Scholar 

  6. Boos N, Krushell R, Ganz R, Muller ME (1997) Total hip arthroplasty after previous proximal femoral osteotomy. J Bone Joint Surg Br 79:247–253

    Google Scholar 

  7. Charnley J (1972) The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. J Bone Joint Surg Br 54:61–76

    Google Scholar 

  8. D’Souza SR, Sadiq S, New AM, Northmore-Ball MD (1998) Proximal femoral osteotomy as the primary operation for young adults who have osteoarthrosis of the hip. J Bone Joint Surg Am 80:1428–1438

    Google Scholar 

  9. Engh CA, Bobyn JD, Glassman AH (1987) Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br 69:45–55

    CAS  PubMed  Google Scholar 

  10. Engh CA, Jr., Claus AM, Hopper RH Jr, Engh CA (2001) Long-term results using the anatomic medullary locking hip prosthesis. Clin Orthop:137–146

    Google Scholar 

  11. Ferguson GM, Cabanela ME, Ilstrup DM (1994) Total hip arthroplasty after failed intertrochanteric osteotomy. J Bone Joint Surg Br 76:252–257

    Google Scholar 

  12. Gerundini M, Avai A, Taglioretti J (1995) Total hip replacement after intertrochanteric osteotomy. Int Orthop 19:84–85

    Google Scholar 

  13. Grubl A, Chiari C, Gruber M, Kaider A, Gottsauner-Wolf F (2002) Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup: a minimum 10-year follow-up. J Bone Joint Surg Am 84-A:425–431

    Google Scholar 

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

    Google Scholar 

  15. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755

    CAS  PubMed  Google Scholar 

  16. Iwase T, Hasegawa Y, Iwasada S, Kitamura S, Iwata H (1999) Total hip arthroplasty after failed intertrochanteric valgus osteotomy for advanced osteoarthrosis. Clin Orthop:175–181

    Google Scholar 

  17. Khalily C, Lester DK (2002) Results of a tapered cementless femoral stem implanted in varus. J Arthroplasty 17:463–466

    Google Scholar 

  18. Kim YH, Oh JH, Oh SH (1995) Cementless total hip arthroplasty in patients with osteonecrosis of the femoral head. Clin Orthop:73–84

    Google Scholar 

  19. Kim YH, Kim JS, Cho SH (1999) Primary total hip arthroplasty with the AML total hip prosthesis. Clin Orthop:147–58

    Google Scholar 

  20. McGrory BJ, Estok DM, 2nd, Harris WH (1998) Follow-up of intertrochanteric osteotomy of the hip during a 25-year period. Orthopedics 21:651–653

    CAS  PubMed  Google Scholar 

  21. Morita S, Yamamoto H, Hasegawa S, Kawachi S, Shinomiya K (2000) Long-term results of valgus-extension femoral osteotomy for advanced osteoarthritis of the hip. J Bone Joint Surg Br 82:824–829

    Google Scholar 

  22. Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop:148–165

    Google Scholar 

  23. Schneider U, Breusch SJ, Thomsen M, Wirtz DC, Lukoschek M (2002) [Influence of implant position of a hip prosthesis on alignment exemplified by the CLS shaft]. Unfallchirurg 105:31–35

    Google Scholar 

  24. Schramm M, Keck F, Hohmann D, Pitto RP (2000) Total hip arthroplasty using an uncemented femoral component with taper design: outcome at 10-year follow-up. Arch Orthop Trauma Surg 120:407–412

    Google Scholar 

  25. Shinar AA, Harris WH (1998) Cemented total hip arthroplasty following previous femoral osteotomy: an average 16-year follow-up study. J Arthroplasty 13:243–253

    Google Scholar 

  26. Siebold R, Scheller G, Schreiner U, Jani L (2001) [Long-term results with the cement-free Spotorno CLS shaft]. Orthopade 30:317–322

    Google Scholar 

  27. Simank HG, Brocai DR, Brill C, Lukoschek M (2001) Comparison of results of core decompression and intertrochanteric osteotomy for nontraumatic osteonecrosis of the femoral head using Cox regression and survivorship analysis. J Arthroplasty 16:790–794

    Google Scholar 

  28. Soballe K, Boll KL, Kofod S, Severinsen B, Kristensen SS (1989) Total hip replacement after medial-displacement osteotomy of the proximal part of the femur. J Bone Joint Surg Am 71:692–697

    Google Scholar 

  29. Spotorno L, Romagnoli S, Ivaldo N, Grappiolo G, Bibbiani E, Blaha DJ, Guen TA (1993) The CLS system. Theoretical concept and results. Acta Orthop Belg 59 [Suppl 1]:144–148

    Google Scholar 

  30. Tonnis D (1976) An evaluation of conservative and operative methods in the treatment of congenital hip dislocation. Clin Orthop:76–88

    Google Scholar 

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Authors and Affiliations

  1. Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany

    Marc Thomsen, Hans Mau, Volker Ewerbeck & Peter R. Aldinger

  2. Department of Orthopedic Surgery, University of Edinburgh, New Royal Infirmary, Edinburgh, Little France, Scottland

    Steffen J. Breusch

  3. Department of Orthopaedic Surgery, Vincenzius Krankenhaus, Konstanz, Germany

    Martin Lukoschek

Authors
  1. Steffen J. Breusch
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  2. Martin Lukoschek
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  3. Marc Thomsen
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  4. Hans Mau
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  5. Volker Ewerbeck
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  6. Peter R. Aldinger
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Correspondence to Peter R. Aldinger.

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Breusch, S.J., Lukoschek, M., Thomsen, M. et al. Ten-year results of uncemented hip stems for failed intertrochanteric osteotomy. Arch Orthop Trauma Surg 125, 304–309 (2005). https://doi.org/10.1007/s00402-005-0800-z

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  • DOI: https://doi.org/10.1007/s00402-005-0800-z

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