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Influences of fit and fill following hip arthroplasty using a cementless short-stem prosthesis

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study consisted in examining the effects of fit and fill ratio of the Metha® prosthesis (BBraun, Aesculap, Tuttlingen, Germany) on radiological and clinical outcomes at a follow-up of 1 year.

Methods

40 patients were included. Fit and fill ratio measurements, radiological and clinical examinations were performed preoperatively and postoperatively. Correlations were established between fit and fill ratio, and potential factors like sex, age, body mass index, Harris Hip Score and changes of radiological signs.

Results

The whole cohort (100 %) had a tight fit and fill ratio (>0.8) at the proximal level and at each follow-up. “Champagne-flute” configuration provoked high distal tight-fit and fill ratio. Poor distal fit and fill ratio compared to the proximal and the mid-stem level was measurable at each follow-up (p < 0.05). Correlations between fit and fill ratio and preoperative femur configurations were detectable.

Conclusions

Implanting the Metha® prosthesis induces tight fit and fill ratio at the proximal and coated sections. Preoperative femur configuration should be considered to achieve best fit and fill situation and therefore excellent primary stability. In most cases “normal” and “stove-pipe” configurations provide good proximal fit and fill. Since “champagne-flute” configuration induces undesirable tight distal fit and fill ratio the size of the Metha® stem should be adequately increased to achieve a more proximal load transmission.

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References

  1. Laine HJ, Pajamäki KJ, Moilanen T, Lehto MU (2001) The femoral canal fill of two different cementless stem designs. The accuracy of radiographs compared to computed tomographic scanning. Int Orthop 25(4):209–213

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Wolff J (1899) Die Lehre von der functionellen Knochengestalt. Virchows Arch 155(2):256–315

    Article  Google Scholar 

  3. van der Wal BC, de Kramer BJ, Grimm B, Vencken W, Heyligers IC, Tonino AJ (2008) Femoral fit in ABG-II hip stems, influence on clinical outcome and bone remodeling: a radiographic study. Arch Orthop Trauma Surg 128(10):1065–72 (Epub 2007 Dec 6)

  4. Poss R, Walker P, Spector M, Reilly DT, Robertson DD, Sledge CB (1988) Strategies for improving fixation of femoral components in total hip arthroplasty. Clin Orthop Relat Res (235):181–194

  5. Issa K, Pivec R, Wuestemann T, Tatevossian T, Nevelos J, Mont MA (2014) Radiographic fit and fill analysis of a new second-generation proximally coated cementless stem compared to its predicate design. J Arthroplasty 29(1):192–198. doi:10.1016/j.arth.2013.04.029 (Epub 2013 May 21)

  6. Kim YH, Kim VE (1993) Uncemented porous-coated anatomic total hip replacement. Results at 6 years in a consecutive series. J Bone Joint Surg Br 75(1):6–13

    CAS  PubMed  Google Scholar 

  7. Aubaniac JM, Argenson JN (1995) Why use a custom-made hip prosthesis? A 10-tear experience. Surg Technol Int IV:457–463

  8. Dorr LD, Lewonowski K, Lucero M, Harris M, Wan Z (1997) Failure mechanisms of anatomic porous replacement I cementless total hip replacement. Clin Orthop Relat Res (334):157–167

  9. Huiskes R (1999) The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop Relat Res (261):27–38

  10. Le D, Smith K, Tanzer D, Tanzer M (2011) Modular femoral sleeve and stem implant provides long-term total hip survivorship. Clin Orthop Relat Res 469(2):508–513. doi:10.1007/s11999-010-524-0

  11. Hirata Y, Inaba Y, Kobayashi N, Ike H, Fujimaki H, Saito T (2013) Comparison of mechanical stress and change in bone mineral density between two types of femoral implant using finite element analysis. J Arthroplasty 28(10):1731–1735. doi:10.1016/j.arth.2013.04.034 (Epub 2013 May 15)

  12. Clarke HJ, Jinnah RH, Cox QG, Curtis MJ (1992) Computerized templating in uncemented total hip arthroplasty to assess component fit and fill. J Arthroplasty 7(3):235–239

  13. Bert JM(1996) Custom total hip arthroplasty. J Arthroplasty 11(8):905–915

  14. Dujardin FH, Mollard R, Toupin JM, Coblentz A, Thomine JM (1996) Micromotion, fit, and fill of custom made femoral stems designed with an automated process. Clin Orthop Relat Res (325):276–289

  15. Engh CA, Massin P (1989) Cementless total hip arthroplasty using the anatomic medullary locking stem. Results using a survivorship analysis. Clin Orthop Relat Res (249):141–158

  16. Jahnke A, Engl S, Altmeyer C, Jakubowitz E, Seeger JB, Rickert M, Ishaque BA (2014) Changes of periprosthetic bone density after a cementless short hip stem: a clinical and radiological analysis. Int Orthop 38(10):2045–2050. doi:10.1007/s00264-014-2370-6 (Epub 2014 Jun 11)

  17. Frndak PA, Mallory TH, Lombardi AV Jr (1993) Translateral surgical approach to the hip. The abductor muscle “split”. Clin Orthop Relat Res (295):135–141

  18. Hardinge K (1982) The direct lateral approach to the hip. J Bone Joint Surg Br 64(1):17–19

    CAS  PubMed  Google Scholar 

  19. 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(4):737–755

    CAS  PubMed  Google Scholar 

  20. Panisello JJ, Herrero L, Herrera A, Canales V, Martinez A, Cuenca J (2006) Bone remodelling after total hip arthroplasty using an uncemented anatomic femoral stem: a three-year prospective study using bone densitometry. J Orthop Surg (Hong Kong) 14(1):32–37

    CAS  Google Scholar 

  21. Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res (141):17–27

  22. Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop Relat Res (235):148–165

  23. Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128

    PubMed  Google Scholar 

  24. Mulliken BD, Nayak N, Bourne RB, Rorabeck CH, Bullas R (1996) Early radiographic results comparing cemented and cementless total hip arthroplasty. J Arthroplasty 11(1):24–33

  25. Ishaque BA, Stürz H, Basad E (2011) Fatigue fracture of a short stem hip replacement: a failure analysis with electron microscopy and review of the literature. J Arthroplasty 26(4):665.e17–665.e20. doi:10.1016/j.arth.2010.05.021 (Epub 2011 Apr 16)

  26. Jakubowitz E, Seeger JB, Lee C, Heisel C, Kretzer JP, Thomsen MN (2009) Do short-stemmed-prostheses induce periprosthetic fractures earlier than standard hip stems? A biomechanical ex vivo study of two different stem designs. Arch Orthop Trauma Surg 129(6):849–855

  27. Effenberger H, Imhof M, Witzel U, Rehart S (2005) Zementfreie Hüftschäfte: Aktueller Stand. Orthopade 34:477–502

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Laboratory of Biomechanics, Justus-Liebig-University Giessen, Paul-Meimberg-Strasse 3, 35392, Giessen, Germany

    Alexander Jahnke, Jörn Bengt Seeger, Markus Rickert & Bernd Alexander Ishaque

  2. Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Klinikstraße 33, 35392, Giessen, Germany

    Sandra Engl, Jörn Bengt Seeger, Markus Rickert & Bernd Alexander Ishaque

  3. ATOS Clinic, Center for Knee and Hip Replacement and Regenerative Joint Surgery, Bismarckstrasse 9-15, 69115, Heidelberg, Germany

    Erhan Basad

Authors
  1. Alexander Jahnke
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  2. Sandra Engl
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  3. Jörn Bengt Seeger
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  4. Erhan Basad
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  5. Markus Rickert
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  6. Bernd Alexander Ishaque
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Correspondence to Alexander Jahnke or Bernd Alexander Ishaque.

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Jahnke, A., Engl, S., Seeger, J.B. et al. Influences of fit and fill following hip arthroplasty using a cementless short-stem prosthesis. Arch Orthop Trauma Surg 135, 1609–1614 (2015). https://doi.org/10.1007/s00402-015-2302-y

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  • DOI: https://doi.org/10.1007/s00402-015-2302-y

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