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Published on: August 4, 2022
High survival in young patients using a second generation uncemented total hip replacement
Marcus R Streit1, Kerstin Schröder, Matthias Körber
1Department of Orthopaedic and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany. marcus.streit@arcor.de
International Orthopaedics
|November 25, 2011
Summary
This study found that uncemented total hip replacements in young patients showed encouraging survival rates and radiological outcomes. The implant combination demonstrated good performance, with no acetabular component revisions for wear or osteolysis.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Arthroplasty Research
Background:
- Total hip arthroplasty (THA) in young patients (<60 years) often faces challenges with acetabular component failure.
- Peri-acetabular osteolysis and accelerated wear are common causes of THA revision in this demographic.
- Contemporary uncemented stems show good long-term results, but acetabular component survival remains a concern.
Purpose of the Study:
- To evaluate the long-term clinical and radiological outcomes of uncemented total hip replacements in patients aged 60 years or younger.
- To assess the survival rates of a specific uncemented acetabular component (Fitmore) combined with a specific stem (CLS Spotorno) in a young patient cohort.
- To investigate the incidence of peri-acetabular osteolysis and wear with metal-on-metal or ceramic-on-polyethylene bearings in this patient group.
Main Methods:
- Retrospective review of 89 uncemented THA cases in 88 patients (≤60 years old) with a minimum 10-year follow-up.
- Utilized the press-fit Fitmore acetabular component with the CLS Spotorno stem.
- Compared outcomes between 28-mm metal-on-metal (Metasul) and 28-mm ceramic-on-conventional polyethylene bearings.
Main Results:
- Mean follow-up was 12 years (range 10-15) in patients with a mean age of 49 years at surgery.
- Overall Kaplan-Meier survival was 94% at 12 years, with no revisions for accelerated wear or osteolysis of the acetabular shell.
- Two acetabular liner revisions were performed (dislocation, pain); other revisions included infection, femoral fracture, and aseptic stem loosening.
Conclusions:
- The combination of the Fitmore acetabular component and CLS Spotorno stem demonstrates encouraging survival rates and radiological outcomes in young, active THA patients.
- This implant configuration appears to mitigate the risks of peri-acetabular osteolysis and wear commonly seen with uncemented acetabular components in this age group.
- Results suggest this implant combination is a viable option for primary THA in younger patient populations.
