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The twenty-year survivorship of two CDH stems with different design features
George Digas1, George Georgiades, Kalliopi Lampropoulou-Adamidou
1Orthopaedic Department, Xanthi Hospital, Xanthi, Greece.
Insights
The Harris CDH stem demonstrated a superior 20-year survival rate (78%) compared to the Charnley CDH stem (63%) in total hip arthroplasty for dislocated hips, reducing aseptic loosening. This finding aids in evaluating new designs for hip reconstruction.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Anatomical abnormalities in dislocated hips necessitate specialized prostheses for proximal femur reconstruction during total hip arthroplasty (THA).
- Previous THA studies highlight the need for effective femoral reconstruction in cases of hip dislocation.
Purpose of the Study:
- To compare the long-term efficacy and survival rates of two specific CDH (congenital dislocation of the hip) stems: the Charnley CDH stem and the Harris CDH stem.
- To evaluate the incidence of aseptic loosening as a failure endpoint for these stems in THA.
Main Methods:
- Retrospective review of clinical records and radiographs from 50 patients (67 hips) treated with THA for low and high hip dislocations between 1987 and 1994.
- Analysis of outcomes for 32 hips reconstructed with Charnley CDH stems and 35 hips with Harris CDH stems.
- Assessment of survival rates at 20 years, with aseptic loosening as the primary failure criterion.
Main Results:
- The Harris CDH stem exhibited a higher 20-year survival rate of 78% compared to the Charnley CDH stem's 63%.
- Aseptic loosening was the reason for revision in 11 Charnley stems (average 14 years post-op) and 6 Harris stems (average 13 years post-op).
Conclusions:
- The Harris CDH stem shows better long-term durability and a lower rate of aseptic loosening than the Charnley CDH stem in THA for dislocated hips.
- These findings provide valuable data for the ongoing evaluation and development of femoral stem designs in hip reconstruction surgery.
Unlabelled:
Previous studies have shown that anatomical abnormalities of the femur in dislocated hips require the application of special CDH prosthesis for the reconstruction of the proximal femur in total hip arthroplasty (THA). We have retrospectively examined the clinical records and radiographs of 50 patients (67 hips) with low and high dislocations treated with THA in our institution, between January 1987 and December 1994. For the reconstruction of the femur, the stainless steel Charnley CDH stem, with polished surface, monoblock and collarless, was used in 32 hips; the Harris CDH stem, made of CoCr, precoated at the proximal part, modular and with collar was used in 35 hips. At the time of the latest follow-up, 11 Charnley and 6 Harris CDH stems had been revised for aseptic loosening at an average of 14 years (range 6-20) and 13 years (range 2-19), respectively. The survival rate at 20 years, with failure for aseptic loosening as the end point, was 63% for the Charnley and 78% for the Harris CDH stems. These results provide a basis for evaluation of newer techniques and designs.
Level Of Evidence:
Therapeutic study, Level IV.
