1
|
Hoornenborg D, Schweden AMC, Sierevelt IN, van der Vis HM, Kerkhoffs G, Haverkamp D. The influence of hydroxyapatite coating on continuous migration of a Zweymuller-type hip stem: a double-blinded randomised RSA trial with 5-year follow-up. Hip Int 2023; 33:73-80. [PMID: 33845623 DOI: 10.1177/11207000211006782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Adding hydroxyapatite to a stem to enhance ingrowth is a matter of debate, even less is known about the long-term effect on stability by adding hydroxyapatite (HA). Continuous migration in the first 2-5 years is an indicator of failed osteointegration or pending failure, enhancing the risk of loosening within 10 years after initial surgery. We performed a double-blinded randomised RSA trial with 5-year follow-up, to compare and analyse migration characteristics of the hydroxyapatite uncoated (HA-) and hydroxyapatite coated (HA+) Zweymuller-type hip stem. PATIENTS AND METHODS In this single-centre prospective randomised controlled trial 51 patients were randomised to receive either a HA- or a HA+ Zweymuller-type hip stem during total hip replacement. After 5 years, 35 patients were still eligible for follow-up evaluation. The migration pattern was measured by use of radio stereometric analysis (RSA) images up to 2 years to evaluate short-term migration, additionally RSA images were obtained 5 years postoperatively to assess late-term and continuous migration. Furthermore, the improvement of clinical outcome was analysed by HSS and HOOS ADL and pain subscales preoperative and after 5 years. RESULTS After initial settling of the implant, no significant migration occurred up to 5 years post-surgery for HA+ as well as HA- prostheses. Continuous migration within the 2-5 years' time interval was not observed for both HA+ nor the HA- group in all directions (p < 0.05). No significant difference between both groups was observed (p < 0.10). In both groups the HHS and HOOS improved significantly at 5 years compared to baseline for both groups. Improvement was not altered by the hydroxyapatite coating. No significant difference between both groups was observed (p > 0.58). CONCLUSIONS Addition of a hydroxyapatite coating did not influence the migration 5 years postoperatively for the Zweymuller-type hip stem.Clinical Trial Protocol number: NL 23524.048.08.
Collapse
Affiliation(s)
| | | | - Inger N Sierevelt
- Xpert Clinics, Orthopaedic Surgery, Amsterdam, The Netherlands.,Spaarne Gasthuis Academy, Haarlem, The Netherlands
| | | | | | | |
Collapse
|
2
|
Karaismailoglu B, Karaismailoglu TN. Femoral Head Perforation After Primary Hip Arthroplasty: Unseen Complication of Ceramic-on-Ceramic Interface: A Case Report. JBJS Case Connect 2021; 11:01709767-202109000-00045. [PMID: 34319929 DOI: 10.2106/jbjs.cc.20.00551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 33-year-old woman, who underwent bilateral ceramic-on-ceramic total hip arthroplasty 3 years previously, presented with right groin pain and mechanical grinding without a history of trauma. Radiographs revealed luxation of the femoral head, and computerized tomography showed perforation of the ceramic femoral head. The patient underwent revision with a metal-on-polyethylene articulation and retained femoral stem. Two years of follow-up yielded good clinical outcome with no evidence of osteolysis or polyethylene wear. CONCLUSION The perforation of a ceramic femoral head should be kept in mind as one of the possible implant failure mechanisms after primary hip arthroplasty.
Collapse
Affiliation(s)
- Bedri Karaismailoglu
- Orthopaedics and Traumatology Department, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, İstanbul, Turkey
| | | |
Collapse
|
3
|
Comment to "Ceramic-on-ceramic articulation in press-fit total hip arthroplasty as a potential reason for early failure, what about the survivors: a ten year follow-up". INTERNATIONAL ORTHOPAEDICS 2021; 45:1379-1380. [PMID: 33725129 DOI: 10.1007/s00264-021-05001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
|
4
|
van Loon J, Vervest AMJS, van der Vis HM, Sierevelt IN, Baas DC, Opdam KTM, Kerkhoffs GMMJ, Haverkamp D. Ceramic-on-ceramic articulation in press-fit total hip arthroplasty as a potential reason for early failure, what about the survivors: a ten year follow-up. INTERNATIONAL ORTHOPAEDICS 2021; 45:1447-1454. [PMID: 33459828 PMCID: PMC8178149 DOI: 10.1007/s00264-020-04895-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE In press-fit total hip arthroplasty (THA), primary stability is needed to avoid micromotion and hereby aseptic loosening, the main reason for early revision. High aseptic loosening revision rates of the seleXys TH+ cup (Mathys Medical) with Ceramys ceramic-on-ceramic (CoC) bearing are seen in literature. Since CoC is presumed to overcome long-term wear-related revisions, the reason for early failure of this cup is important to clarify. The aim is to investigate its ten year outcomes and differentiate between potential causes and identify risk factors for aseptic loosening. METHODS Retrospective screening of a prospectively documented series of 315 THAs was performed. Primary outcome was cumulative incidence of cup revision due to aseptic loosening. Secondary outcomes were component revision and reoperation. Additionally, potential predictive factors for aseptic loosening were evaluated. RESULTS At the median follow-up of 9.7 years [IQR 4.4; 10.3], 48 TH+ (15.2%) were revised due to aseptic loosening. Competing risk analysis showed a ten year cumulative incidence of cup revision due to aseptic loosening of 15.6% (95% CI 12.0-20.2). Stabilization of early revision rates was observed, following a high rate of respectively 81.3% (n = 39) and 95.8% (n = 46) within the first two and three years. No significant predictive factors for aseptic loosening were found. CONCLUSION The ten year results of seleXys TH+ cup with Ceramys CoC bearing showed an unacceptable high aseptic loosening rate, which stabilized over time after a high early failure incidence. This could be attributed to a problem with osseointegration during the transition of primary to definitive stability.
Collapse
Affiliation(s)
- J van Loon
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands.,Department of Orthopaedic Surgery, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 15, 1105, AZ, Amsterdam, The Netherlands.,Department of Orthopaedic Surgery, Tergooi, Van Riebeeckweg 212, 1213, XZ, Hilversum, The Netherlands
| | - A M J S Vervest
- Department of Orthopaedic Surgery, Tergooi, Van Riebeeckweg 212, 1213, XZ, Hilversum, The Netherlands
| | - H M van der Vis
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands
| | - I N Sierevelt
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands.,Department of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134, TM, Hoofddorp, The Netherlands
| | - D C Baas
- Department of Orthopaedic Surgery, Tergooi, Van Riebeeckweg 212, 1213, XZ, Hilversum, The Netherlands
| | - K T M Opdam
- Department of Orthopaedic Surgery, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 15, 1105, AZ, Amsterdam, The Netherlands
| | - G M M J Kerkhoffs
- Department of Orthopaedic Surgery, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 15, 1105, AZ, Amsterdam, The Netherlands
| | - D Haverkamp
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands.
| |
Collapse
|
5
|
Hoornenborg D, van Loon J, de Waard S, Sierevelt IN, Opdam KTM, Kerkhoffs GMMJ, Haverkamp D. Dynamic trial fitting by an expanding trial cup does not jeopardize primary acetabular component stability. Clin Biomech (Bristol, Avon) 2020; 78:105077. [PMID: 32559463 DOI: 10.1016/j.clinbiomech.2020.105077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 02/13/2020] [Accepted: 06/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Trial fitting of the acetabular component in uncemented total hip replacement is traditionally done by trial cups. Since trial cups do not resemble the real press-fit obtained by the definitive cup, a dynamic trial inserter, called the X-pander ®, was developed to mimic the real amount of press-fit. However, the concern is raised of losing the initial press-fit by using the X-pander® due to pre-expansion of the acetabulum. The purpose of this study was to assess if there is a difference in primary stability between both methods. METHODS A biomechanical randomized study was performed with bovine calf acetabula, with randomization between either using the X-pander® or the traditional trial cups to assess primary stability. The primary outcome was the force needed to achieve lever out of the implanted cup (Anexys, Mathys or Trident, Stryker), measured in Newton meter (Nm) with a biomechanical testing set up. FINDINGS In total, 54 cups (19 Anexys, 35 Trident) were inserted and tested after randomized trial fitting. Overall mean lever out was 45.1 Nm (SD 14.6) for the X-pander® group and 45.0 Nm (SD 14.5) for the trial cups group. After adjustment for potential confounders (cup size and type) mixed model analysis did not reveal a significant difference in lever out force between both testing devices (mean 1.0 Nm, 95%CI (-5.9; 8.0), p = .77). INTERPRATION Initial press-fit of the implanted cup is not lost by pre-expansion as done with dynamic trial fitting with the X-pander®.
Collapse
Affiliation(s)
- D Hoornenborg
- Xpert Orthopedie Amsterdam/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA Amsterdam, the Netherlands.
| | - J van Loon
- Xpert Orthopedie Amsterdam/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA Amsterdam, the Netherlands; Academic Medical Center Amsterdam, Department of Orthopedic Surgery, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands.
| | - S de Waard
- Xpert Orthopedie Amsterdam/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA Amsterdam, the Netherlands
| | - I N Sierevelt
- Xpert Orthopedie Amsterdam/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA Amsterdam, the Netherlands.
| | - K T M Opdam
- Academic Medical Center Amsterdam, Department of Orthopedic Surgery, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands.
| | - G M M J Kerkhoffs
- Academic Medical Center Amsterdam, Department of Orthopedic Surgery, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands.
| | - D Haverkamp
- Xpert Orthopedie Amsterdam/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA Amsterdam, the Netherlands.
| |
Collapse
|
6
|
Fulin P, Pokorny D, Hert J, Sosna A. Results of 198 primary total hip arthroplasties using the Delta PF-FIT system with ceramic-on-ceramic articulating surfaces with average seven years follow up. BMC Musculoskelet Disord 2020; 21:311. [PMID: 32429881 PMCID: PMC7236923 DOI: 10.1186/s12891-020-03253-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 03/31/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The lifetime implants is a key parameter that the surgeon should take into account at the time of the primary total hip arthroplasty (THA). The aim of this study was a clinical and radiographical evaluation of the Delta PF-FIT (LimaCorporate, Italy) THA system with ceramic-on-ceramic articulations. We have not found a clinical or radiographical assessment of this implant in available published literature. METHODS A total of 197 (F = 94, M = 103) primary THAs were evaluated in 163 patients with a mean follow-up of 7.7 years (range 5.1-11.2 years (SD ± 1.5)) Harris hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis index (WOMAC) were used for the clinical evaluation. The statistical evaluation was processed by standard statistical methods. The study was approved by Ethic Committee of the University Hospital Motol (Reference No. EK-73/19). RESULTS The mean HHS score was found to be 97.59 points (61-100 range with a ± 5.13 SD, preoperative HSS was 51.21, range 28-73 with a ± 4,77 SD). 186 THAs were evaluated as excellent (90-100 points), 9 THAs rated as good (80-89 points), 1 THA was rated as fair (70-79) points and 1 THA rated as poor (less than 70 points). The mean WOMAC score was 97.38 points (65-100 range with a ± 5.18 SD, preoperative was 50,12, range 27-69 with a ± 4.85 SD). We documented an overall 99.49% Kaplan-Meier survival with a mean follow-up of 7.7 years with the FIT (LimaCorporate) stem revision and any component revision as the endpoint. With the Delta PF (LimaCorporate) cup revision as the endpoint, the survival was 100%. We have not found a previously published clinical or radiographical review of this THA system, the study shows a comparison with other THA implants. CONCLUSION Evaluation of the Delta-PF-FIT (LimaCorporate, Italy) THA system with the use of ceramic-on-ceramic BIOLOX®Delta articulation surfaces shows very good outcomes.
Collapse
Affiliation(s)
- Petr Fulin
- Orthopaedic Clinic 1st Faculty of Medicine Charles University and Motol University Hospital, V Uvalu 84, 15006, Prague, Czech Republic.
| | - David Pokorny
- Orthopaedic Clinic 1st Faculty of Medicine Charles University and Motol University Hospital, V Uvalu 84, 15006, Prague, Czech Republic
| | - Jan Hert
- Orthopaedic Clinic 1st Faculty of Medicine Charles University and Motol University Hospital, V Uvalu 84, 15006, Prague, Czech Republic
| | - Antonin Sosna
- Orthopaedic Clinic 1st Faculty of Medicine Charles University and Motol University Hospital, V Uvalu 84, 15006, Prague, Czech Republic
| |
Collapse
|
7
|
Halasi T, Kieser D, Frampton CM, Hooper GJ. Midterm analysis of the seleXys cup with ceramic inlay. Arthroplast Today 2016; 3:171-175. [PMID: 28913402 PMCID: PMC5585767 DOI: 10.1016/j.artd.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/21/2016] [Accepted: 10/01/2016] [Indexed: 11/29/2022] Open
Abstract
Background Ceramic-on-ceramic (CoC) articulations in total hip replacement (THR) has been accepted as giving reliable mid-term results; however recent studies have reported higher revision rates of some implants. This study analyses the nationwide results of the seleXys TPS cup and the Bionit2 liner (Mathys, Bettlach, Switzerland) with respect to implant survival, cause for revision and mortality rates compared to other CoC articulations using the same stem. Methods Utilising the New Zealand Joint Registry, we compared the seleXys TPS cup with Bionit2 liner used with an uncemented Twinsys femoral stem to every other uncemented CoC THR using the same stem. Multivariate analysis was used to determine the effects of patient age, gender, ASA score and implant head size on these rates. Results Between 2006 and 2013 a total of 1035 seleXys THRs were performed on 862 patients. The comparison group had 375 THRs on 280 patients. There were 77 revisions (1.4/100 component years) in the study group and two in the comparison group (0.12/100 component years). Overall hazards ratio for revision was 12.22 times higher and female gender was associated with an increased risk (hazards ratio 1.77). Causes for revision were disturbing noises (23.4%), acetabular loosening (20.8%), and fracture of the liner (18.2%). Mortality rates were not significantly different (P = .567). Conclusions The seleXys TPS cup with the Bionit2 ceramic inlay coupling has an unacceptably high failure rate. We recommend avoiding this implant coupling and would advise that patients treated with this implant need close clinical and radiological follow-up.
Collapse
Affiliation(s)
| | - David Kieser
- Corresponding author. Department of Orthopaedic Surgery and MSM, University of Otago, Riccarton Avenue, Christchurch, New Zealand. Tel.: +64 3 364 0640.Department of Orthopaedic Surgery and MSMUniversity of OtagoRiccarton AvenueChristchurchNew Zealand
| | | | | |
Collapse
|
8
|
High failure rate of a new pressfit cup in mid-term follow-up. INTERNATIONAL ORTHOPAEDICS 2015; 39:1813-7. [DOI: 10.1007/s00264-015-2872-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
|