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Published on: May 25, 2012
Not all cementless femoral stems are created equal but the results may be comparable
S W Carlson1, S S Liu1, J J Callaghan1
1University of Iowa, University of Iowa College of Medicine, 01073 JPP, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Insights
This study compared three cementless femoral components for total hip arthroplasty (THA). All designs showed excellent survivorship over ten years, with 97-100% success when aseptic loosening was the endpoint.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Clinical Trials
Background:
- Total hip arthroplasty (THA) aims to restore function and reduce pain.
- Cementless femoral components are widely used, with various designs influencing long-term outcomes.
- Assessing survivorship and radiographic results of different designs is crucial for clinical decision-making.
Purpose of the Study:
- To compare the ten-year survivorship and radiographic outcomes of three distinct cementless femoral component designs for THA.
- To evaluate the effectiveness of different femoral stem philosophies in a prospective setting.
Main Methods:
- Prospective evaluation of three consecutive patient series undergoing THA with different cementless femoral stems.
- Cohort 1: Porous-coated anatomic (PCA) stem (n=100 hips).
- Cohort 2: Extensively porous-coated (Prodigy) stem (n=100 hips).
- Cohort 3: Proximally porous-coated triple-tapered (Summit) stem (n=100 hips).
Main Results:
- Kaplan-Meier survivorship at 10 years for revision due to any reason: Cohort 1 (91%), Cohort 2 (88%), Cohort 3 (95%).
- Survivorship at 10 years for aseptic loosening: Cohort 1 (97%), Cohort 2 (100%), Cohort 3 (100%).
- All three designs demonstrated high survivorship, particularly concerning aseptic loosening.
Conclusions:
- The three cementless femoral components, despite differing design philosophies, exhibited excellent survivorship at the ten-year follow-up.
- Excellent long-term results were observed, especially when considering aseptic loosening as the primary endpoint.
- These findings support the efficacy of various cementless femoral stem designs in THA.
Aims:
The aim of this study was to compare the survivorship and radiographic outcomes at ten-year follow-up of three prospective consecutive series of patients each of which received a different design of cementless femoral components for total hip arthroplasty (THA).
Patients And Methods:
In Cohort 1, 91 consecutive patients (100 hips) underwent THA with a cementless porous-coated anatomic femoral stem (PCA) between October 1983 and January 1986. In Cohort 2, 86 consecutive patients (100 hips) underwent THA with an extensively porous-coated cementless femoral stem (Prodigy) between June 1994 and October 1997. In Cohort 3, 88 consecutive patients (100 hips) underwent THA with a proximally porous-coated triple-tapered cementless stem (Summit) between April 2002 and October 2003. All three groups underwent prospective clinical and radiographic evaluation.
Results:
Kaplan-Meier survivorship analysis of Cohort 1 was 91% (95% confidence interval (CI) 88 to 94) with an endpoint of revision for any reason and 97% (95% CI 95 to 99) with aseptic loosening as the endpoint. Survivorship of Cohort 2 was 88% (95% CI 79 to 97) for revision for any reason and 100% for aseptic loosening. Survivorship of Cohort 3 was 95% (95% CI 91 to 99) for revision for any reason and 100% with aseptic loosening as the endpoint.
Conclusion:
With revision for aseptic loosening of the femoral component as the endpoint, the three femoral components with different design philosophies demonstrated excellent survivorship, ranging from 97% to 100% at ten years. Cite this article: Bone Joint J 2017;99-B(1 Supple A):14-17.
