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Cemented titanium stems show high migration: transprosthetic drainage system has no advantage over third-generation
C Pabinger1, A Kröner, A Lange
1Department of Orthopaedics, Donauspital /SMZ-Ost, Langobardenstrasse 122, 1220 Vienna, Austria. pabinger@gmx.at
Archives of Orthopaedic and Trauma Surgery
|May 29, 2004
Summary
This study found that cemented titanium stems showed poor long-term survival, with significant subsidence and radiolucent lines. A transprosthetic drainage system (TDS) did not improve outcomes compared to conventional cementing.
Area of Science:
- Orthopedic surgery
- Biomaterials engineering
Background:
- A novel cemented titanium hip stem with a transprosthetic drainage system (TDS) was evaluated clinically.
- Previous laboratory results for the TDS were excellent.
Purpose of the Study:
- To assess the clinical efficacy and long-term survival of a new cemented titanium hip stem.
- To compare conventional cementing with a TDS for cement mantle quality.
Main Methods:
- Prospective study of 22 total hip replacements using cemented titanium stems and Zweymüller cups.
- Comparison of conventional cementing (10 stems) versus TDS (12 stems).
- Radiographic assessment (migration, subsidence, radiolucency) and clinical follow-up for up to 7 years.
Main Results:
- Over 50% of stems exhibited significant subsidence and progressive radiolucent lines.
- No significant differences in radiological or clinical outcomes between conventional cementing and TDS.
- Two patients in the TDS group required revision surgery at 7 years.
Conclusions:
- Cementing titanium stems of this design is not recommended due to unfavorable long-term survival.
- The transprosthetic drainage system (TDS) offered no significant advantage over conventional cementing techniques.