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The migration pattern of a cementless hydroxyapatite-coated titanium stem under immediate full weight-bearing: a randomized controlled trial using model-based RSA

(1) Background: High primary stability is important for the long-term survival of cementless femoral stems in total hip arthroplasty (THA). The objective of this study was to investigate the migration pattern of a hydroxyapatite-coated cementless hip stem developed for minimally invasive surgery usi...

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Main Authors: Reiner, Tobias (Author) , Sonntag, Robert (Author) , Kretzer, Jan Philippe (Author) , Clarius, Michael (Author) , Jakubowitz, Eike (Author) , Weiss, Stefan (Author) , Ewerbeck, Volker (Author) , Merle, Christian (Author) , Moradi, Babak (Author) , Kinkel, Stefan (Author) , Gotterbarm, Tobias (Author) , Hagmann, Sébastien (Author)
Format: Article (Journal)
Language:English
Published: 2 July 2020
In: Journal of Clinical Medicine
Year: 2020, Volume: 9, Issue: 7
ISSN:2077-0383
DOI:10.3390/jcm9072077
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm9072077
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Author Notes:Tobias Reiner, Robert Sonntag, Jan Philippe Kretzer, Michael Clarius, Eike Jakubowitz, Stefan Weiss, Volker Ewerbeck, Christian Merle, Babak Moradi, Stefan Kinkel, Tobias Gotterbarm and Sébastien Hagmann
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Summary:(1) Background: High primary stability is important for the long-term survival of cementless femoral stems in total hip arthroplasty (THA). The objective of this study was to investigate the migration pattern of a hydroxyapatite-coated cementless hip stem developed for minimally invasive surgery using model-based radiostereometric analysis (RSA). (2) Methods: In this randomized controlled trial, 44 patients with an indication for cementless primary THA were randomly allocated to receive either the SL-PLUS MIA stem, developed for minimally invasive surgery, or the SL-PLUS stem (Smith & Nephew Orthopaedics, Baar, Switzerland) which served as a control group. Unlimited weight-bearing was permitted postoperatively in both groups. Model-based RSA was performed after six weeks and after 3, 6, 12 and 24 months postoperatively. (3) Results: Mean total stem subsidence at two-year follow-up was 0.40 mm (SD 0.66 mm) in the SL-PLUS group and 1.08 mm (SD 0.93 mm) in the SL-PLUS MIA group (p = 0.030). Stem subsidence occurred during the first six weeks after surgery, indicating initial settling of the stem under full weight-bearing. Both stem designs showed good osseointegration and high secondary stability with no further migration after initial settling. (4) Conclusions: Settling of a cementless straight femoral stem occurs during the first six weeks after surgery under full weight-bearing. Although initial stem migration was higher in the SL-PLUS MIA group, it had no influence on secondary stability. All implants showed good osseointegration and high secondary stability with no signs of implant loosening during this two-year follow-up period.
Item Description:Gesehen am 24.09.2020
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm9072077

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