Cementless total hip replacement: a prospective clinical study of the early functional and radiological outcomes of three different hip stems

Introduction Optimal fixation of cementless total hip stems is essential for long-term survival rates. Aim The purpose of this prospective study was to evaluate the early clinical and radiological outcomes of two new total hip stems with metaphyseal (Symax ® ) and predominantly diaphyseal (Hipstar ®...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2010, Vol.130 (1), p.125-133
Main Authors: Bergschmidt, Philipp, Bader, Rainer, Finze, Susanne, Gankovych, Alexander, Kundt, Guenther, Mittelmeier, Wolfram
Format: Article
Language:English
Subjects:
Adult
Aged
Arthroplasty, Replacement, Hip - methods
Chi-Square Distribution
Female
Hip Prosthesis
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopaedic Outcome Assessment
Orthopedics
Prospective Studies
Prosthesis Design
Recovery of Function
Statistics, Nonparametric
Treatment Outcome
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Summary:Introduction Optimal fixation of cementless total hip stems is essential for long-term survival rates. Aim The purpose of this prospective study was to evaluate the early clinical and radiological outcomes of two new total hip stems with metaphyseal (Symax ® ) and predominantly diaphyseal (Hipstar ® ) anchoring principles in comparison to the well-established straight Zweymueller (SL-Plus ® ) stem. Method Clinical and radiological evaluations of 74 patients were undertaken preoperatively as well as at 6 and 12 months postoperatively using the Harris Hip Score (HHS) and Western Ontario and McMaster Universities-Score. Results During follow-up no stem had to be revised. The mean preoperative HHS of the three study groups amounted to 54.6 ± 15.7 points. At the 12 months follow-up the mean HHS in the SL-Plus group ( n  = 22) was 88.3 ± 10.5 points, in the Hipstar group ( n  = 25) 83.3 ± 15.0 and the in Symax group ( n  = 27) 83.6 ± 15.1. Due to stress shielding the straight Hipstar stem revealed radiolucent lines in the proximal Gruen zones of about 60%, whereas the SL-Plus stem showed significantly more radiolucent lines (87%). However, subsequent long-term studies must be carried out in order to clarify if the progression of radiolucent lines may influence the clinical result and implant longevity.
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-009-0907-8