The migration pattern of the Charnley femoral stem: a five-year follow-up RSA study in a well-functioning patient group

Migration measurement of the cemented Lubinus SP II hip stem - a 10-year follow-up using radiostereometric analysis

In a previous radiostereometric analysis (RSA) of the Lubinus SP II (Link, Hamburg, Germany), which is one of the most often used cemented hip stems worldwide, our research group detected a very small but statistically significant distal migration of -0.03±0.17 mm 2 years after surgery compared to the postoperative radiograph. Maximum subsidence occurred between 6 and 12 months. The implant appeared to have stabilized after 2 years. The mean value of maximum total point motion (MTPM) was 0.99±0.69 mm, which was detected 2 years after surgery. The purpose of this study was to analyze the migration pattern and to verify the predictive value of short-term RSA of the Lubinus SP II stem after 10 years. After a follow-up of 5 and 10 years, 38 and 27 out of 100 patients remained available for further assessment, respectively. No statistically significant implant translation or rotation was found along or about the axes of the global coordinate system 5 and 10 years after surgery with respect to the postoperative radiograph. Furthermore, the MTPM was stable in both follow-up periods. The results suggest that the Lubinus SP II hip stem is still stable 10 years after surgery, supporting that determining prognosis by short-term RSA follow-up of 2 years could be an appropriate tool for appraisal of implant behavior 10 years after surgery.

Analysis of migration of the Nanos® short-stem hip implant within two years after surgery

PURPOSE

Short-stem implants provide a bone-preserving alternative in total hip arthroplasty. However, some evidence exists that the smaller implant-bone contact surface may compromise primary stability and impair osseo-integration. The purpose of this study was to analyse the migration characteristics of the Nanos® short stem over two years by means of model-based roentgen stereophotogrammetric analysis (MBRSA).

METHODS

Eighteen patients aged 53.6 ± 7.2 years were included. After being treated with a Nanos implant, 14 patients were followed-up radiologically at three, six, 12 and 24 months by means of MBRSA. Early implant migration was calculated. Clinical data have been assessed in addition.

RESULTS

Highest translational migration was observed with a mean value of -0.22 ± 0.39 mm along the proximo-distal axis after three months and highest rotational migration with 0.8 ± 3.2° also around the y-axis after two years. The resulting total migration was 0.46 ± 0.31 mm, with the largest proportion occurring within three months after surgery (0.40 ± 0.34 mm).

CONCLUSION

The Nanos short-stem hip implant shows only a slight initial migration within three months after implantation, followed by secondary stabilisation. These results suggest both good primary stability and osseo-integration, suggesting a low risk of aseptic loosening.