1
|
Ramsodit KR, Sierevelt IN, Janssen ERC, Kaarsemaker S, Haverkamp D. Mid-term clinical outcomes of the uncemented Robert Mathys pressfit cup. World J Clin Cases 2024; 12:3684-3691. [PMID: 38994294 PMCID: PMC11235464 DOI: 10.12998/wjcc.v12.i19.3684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/25/2024] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The use of uncemented cups during total hip arthroplasty (THA) has gained popularity in recent years. The Robert Mathys (RM) pressfit cup, an uncemented monoblock implant is expected to preserve bone density due to its composition and external surface, while reducing backside wear with its monoblock construction. These factors should lead to a high survival rate of the implant. AIM To evaluate the mid-term survival and functional outcome of the RM Pressfit cup in a large study population. METHODS Between 2011 and 2020, we included 1324 patients receiving a primary THA using the RM pressfit cup. Final clinical follow-up was performed at 2 years postoperatively with the Dutch arthroplasty register used to assess implant status thereafter. Revision for acetabular failure and reason for revision were reported to evaluate implant survival, while the hip disability and osteoarthritis outcome score (HOOS) scores were used to assess functional outcome. RESULTS The mean age at surgery was 64.9 years. The mean follow-up was 4.6 years. Of the 1324 THAs performed, 13 needed cup revisions within 5 years after index THA: 5 due to aseptic loosening, 6 due to infection, 2 due to dislocation and 2 due to other causes. This resulted in a 5-year cup survival of 98.8% (95%CI: 98.1-99.5). Nine of the cup revisions occurred within the first year after index THA. HOOS scores increased significantly in all domains during the first year and levelled out during the second year. CONCLUSION In the present study, the RM pressfit cup demonstrated excellent clinical outcomes at mid-term follow-up; however, future studies are needed to assess the long-term outcomes of this acetabular implant.
Collapse
Affiliation(s)
- Kishan Ritek Ramsodit
- Department of Orthopedic Surgery, Xpert Clinics Amsterdam, Amsterdam 1101EA, North-Holland, Netherlands
| | - Inger N Sierevelt
- Department of Orthopedic Surgery, Xpert Clinics Amsterdam, Amsterdam 1101EA, North-Holland, Netherlands
- Department of Orthopedic, Spaarne Gasthuis Academy, Hoofddorp 2134 TM, Netherlands
| | - Esther R C Janssen
- Department of Orthopaedic Surgery, Viecuri Medical Centre, Venlo 5912 BL, Netherlands
| | - Sjoerd Kaarsemaker
- Department of Orthopaedic Surgery, Viecuri Medisch Centrum, Venlo 5912 BL, Netherlands
| | - Daniël Haverkamp
- Department of Orthopedic Surgery, Xpert Clinics Amsterdam, Amsterdam 1101EA, North-Holland, Netherlands
| |
Collapse
|
2
|
Zgouridou A, Kenanidis E, Potoupnis M, Tsiridis E. Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:1219-1251. [PMID: 37768398 PMCID: PMC10858160 DOI: 10.1007/s00590-023-03691-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/13/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE Four joint arthroplasty registries (JARs) levels exist based on the recorded data type. Level I JARs are national registries that record primary data. Hospital or institutional JARs (Level II-IV) document further data (patient-reported outcomes, demographic, radiographic). A worldwide list of Level II-IV JARs must be created to effectively assess and categorize these data. METHODS Our study is a systematic scoping review that followed the PRISMA guidelines and included 648 studies. Based on their publications, the study aimed to map the existing Level II-IV JARs worldwide. The secondary aim was to record their lifetime, publications' number and frequency and recognise differences with national JARs. RESULTS One hundred five Level II-IV JARs were identified. Forty-eight hospital-based, 45 institutional, and 12 regional JARs. Fifty JARs were found in America, 39 in Europe, nine in Asia, six in Oceania and one in Africa. They have published 485 cohorts, 91 case-series, 49 case-control, nine cross-sectional studies, eight registry protocols and six randomized trials. Most cohort studies were retrospective. Twenty-three per cent of papers studied patient-reported outcomes, 21.45% surgical complications, 13.73% postoperative clinical and 5.25% radiographic outcomes, and 11.88% were survival analyses. Forty-four JARs have published only one paper. Level I JARs primarily publish implant revision risk annual reports, while Level IV JARs collect comprehensive data to conduct retrospective cohort studies. CONCLUSIONS This is the first study mapping all Level II-IV JARs worldwide. Most JARs are found in Europe and America, reporting on retrospective cohorts, but only a few report on studies systematically.
Collapse
Affiliation(s)
- Aikaterini Zgouridou
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, 56403, Thessaloniki, Greece
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 57001, Thessaloniki, Greece
| | - Eustathios Kenanidis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, 56403, Thessaloniki, Greece.
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 57001, Thessaloniki, Greece.
| | - Michael Potoupnis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, 56403, Thessaloniki, Greece
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 57001, Thessaloniki, Greece
| | - Eleftherios Tsiridis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, 56403, Thessaloniki, Greece
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 57001, Thessaloniki, Greece
| |
Collapse
|
3
|
Anderl C, Steinmair M, Hochreiter J. Bone Preservation in Total Hip Arthroplasty. J Arthroplasty 2022; 37:1118-1123. [PMID: 35121089 DOI: 10.1016/j.arth.2022.01.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/27/2021] [Accepted: 01/22/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Preserving bone stock in younger and more active patients after total hip arthroplasty (THA) is important for future revision. Newer prosthesis designs, including short femoral stems and isoelastic acetabular cups, are likely to preserve more bone stock. However, long-term follow-up studies on bone remodeling after short-stem THA with an isoelastic monoblock acetabular cup are few. Therefore, we evaluated bone preservation after THA using these prostheses at a 5-year follow-up. METHODS This prospective observational study is a 5-year follow-up of our previously reported 2-year observational study on the same cohort of patients. We included 45 patients with primary osteoarthritis treated with a calcar-guided femoral short-stem prosthesis and a monoblock press-fit acetabular cup. We evaluated bone mineral density (BMD) around the prostheses using dual-energy X-ray absorptiometry and reported functional outcomes preoperatively and at 3, 12, 24, and 60 months postoperatively. All complications were recorded. RESULTS At the final follow-up, the BMD was comparable with that at 24 months in Gruen zones 3, 4, 5, 6, and 7, whereas it significantly differed in Gruen zones 1 (P < .0001) and 2 (P < .004). On the acetabular side, the BMD leveled off similarly in all DeLee and Charnley zones between 24 and 60 months (P > .05). Moreover, all measured clinical outcomes significantly improved (P < .001). One perioperative dislocation was reported. CONCLUSION Patients undergoing THA with a calcar-guided femoral short-stem prosthesis and a monoblock acetabular cup can expect preservation of bone stock over a longer follow-up with excellent clinical outcomes and few complications.
Collapse
Affiliation(s)
- Conrad Anderl
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria
| | - Martin Steinmair
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria
| | - Josef Hochreiter
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria
| |
Collapse
|
4
|
Comtesse S, de Gast A, Rehbein P, French G, Helmy N, Becker R, Dominkus M, Beck M. Wear and migration are not influenced by head size in a vitamin E-infused highly cross-linked polyethylene acetabular cup. Orthop Traumatol Surg Res 2021; 107:102644. [PMID: 33384276 DOI: 10.1016/j.otsr.2020.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 03/19/2020] [Accepted: 03/24/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Aseptic loosening and periprosthetic osteolysis are frequent complications in total hip arthroplasty requiring revision surgery. Highly cross-linked polyethylene (HXLPE) implants have improved wear resistance, permitting larger femoral heads. However, such implants may experience surface cracking, mechanical failure, and oxidative damage. Vitamin E-infused HXLPE (VEPE) implants were therefore developed to reduce oxidation without compromising mechanical strength. We addressed the following questions: (1) Does femoral head size affect the midterm annual polyethylene wear rates of VEPE acetabular cups? (2) Does femoral head size affect the midterm migration rates of VEPE acetabular cups? (3) Are clinical outcomes affected by femoral head size? HYPOTHESIS Annual wear rate, migration rate, and clinical outcomes of VEPE acetabular cups are independent of femoral head size. PATIENTS AND METHODS This was a prospective, multicentre, observational study of patients that underwent total hip arthroplasty. Hips were grouped according to the size of femoral head implanted (28 mm, 32 mm, and 36 mm). We determined annual wear rate and migration rate of VEPE acetabular cups using the Einzel-Bild-Röntgen-Analyse software. Clinically, we assessed the Harris Hip Score and visual analog score for pain and satisfaction. RESULTS We followed 253 patients (267 hips) for a mean of 55.0±20.6 months in the 28 mm, 46.2±21.4 months in the 32 mm, and 43.8±22.6 months in the 36 mm group. The annual wear rate was 0.025 mm per year from 1 year to the last follow-up and remained similar between the groups (p>0.05). Also, mean two-dimensional migration rates did not exceed 0.05 mm from 2 years to the last follow-up and remained similar between the groups (p=0.355). Finally, clinical outcomes also did not differ between the groups (p>0.05). Two patients required revision surgery. DISCUSSION Femoral head size did not influence midterm annual wear rate, migration rate, and clinical outcomes of VEPE acetabular cups. Furthermore, wear and cup migration rates were below the reported values leading to osteolysis and aseptic loosening. Nevertheless, studies with extended follow-up periods will be necessary to confirm these results in the long term. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Simon Comtesse
- Mathys Ltd Bettlach, Robert-Mathys Strasse 5, 2544 Bettlach, Switzerland
| | - Arthur de Gast
- Diakonessenhuis Utrecht, Bosboomstraat 1, 3582 KE Utrecht, Netherlands; Clinical Orthopedic Research Centre midden-Nederland, Diakonessenhuis Zeist, Jagersingel 1, 3707 HL Zeist, Netherlands
| | - Philipp Rehbein
- St. Josefs-Hospital Wiesbaden, Beethovenstraße 20, 65189 Wiesbaden, Germany
| | - Gary French
- Ormiston Hospital, 125, Ormiston Road, Flat Bush, 2016 Manukau, New Zealand
| | - Naeder Helmy
- Bürgerspital Solothurn, Schöngrünstrasse 42, 4500 Solothurn, Switzerland
| | - Roland Becker
- Zentrum für Orthopädie und Unfallchirurgie, Endoprothesenzentrum West-Brandenburg, Medizinische Hochschule Theodor Fontane, 14776 Brandenburg/Havel, Germany
| | - Martin Dominkus
- Orthopädisches Spital Speising, Speisinger Straße 109, 1130 Wien, Austria; Sigmund-Freud University, Campus Prater Freudplatz 1, 1020 Wien, Austria
| | - Martin Beck
- Luzerner Kantonsspital, Spitalstrasse, 6000 Luzern, Switzerland.
| |
Collapse
|
5
|
Anderl C, Mattiassich G, Ortmaier R, Steinmair M, Hochreiter J. Peri-acetabular bone remodelling after uncemented total hip arthroplasty with monoblock press-fit cups: an observational study. BMC Musculoskelet Disord 2020; 21:652. [PMID: 33023553 PMCID: PMC7539379 DOI: 10.1186/s12891-020-03675-7] [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: 03/23/2020] [Accepted: 09/24/2020] [Indexed: 11/23/2022] Open
Abstract
Background Bone stock preservation in total hip replacement is essential to allow for later revisions in an increasingly younger and fitter index patient population. While contemporary modular press-fit acetabular cups lead to rigid fixation with equatorial stress and central osteolysis, more elastic fixation may cause different peri-acetabular bone remodelling. The purpose of this study was to investigate changes in peri-acetabular bone mineral density (BMD) in uncemented elastic fixation with monoblock press-fit cups. Methods This prospective observational study included 45 patients with monoblock cups. We evaluated peri-acetabular BMD using dual-energy X-ray absorptiometry and reported functional outcomes and complications. Results At a mean follow-up of 24.2 ± 2.2 months, we found that BMD stabilised in DeLee and Charnley zones I and III and recovered to baseline value in zone II. The mean Harris Hip Scores improved significantly from 56.9 ± 20.0 to 97.2 ± 4.0 (p < 0001). Other than one peri-operative dislocation, we saw no post-operative complications. Conclusions We found favourable adaptive bone changes with BMD stabilisation in the equatorial zones and recovery to pre-operative values in the central zone. Additionally, excellent clinical outcomes and few prosthesis-related complications strengthened the favourable results of monoblock acetabular cups. Trial registration Registration number DRKS00017076.
Collapse
Affiliation(s)
- Conrad Anderl
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4020, Linz, Austria.
| | - Georg Mattiassich
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4020, Linz, Austria.,Ludwig-Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200, Vienna, Austria
| | - Reinhold Ortmaier
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4020, Linz, Austria.,Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria
| | - Martin Steinmair
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4020, Linz, Austria
| | - Josef Hochreiter
- Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4020, Linz, Austria
| |
Collapse
|