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Total hip arthroplasty with a cemented, polished, collared femoral stem and a cementless acetabular component. A follow-up study at a minimum of ten years.
J Bone Joint Surg Am 2007; 89(1):126-32JB

Abstract

BACKGROUND

Recent studies have suggested that cemented femoral components with a polished surface may provide superior long-term fixation when compared with femoral components with a roughened surface. The purpose of this study was to evaluate the results of total hip arthroplasty with a cemented femoral component with a polished surface finish and compare them with the results of total hip arthroplasty performed with a similar design of cemented femoral component with a rougher surface finish.

METHODS

We retrospectively reviewed a consecutive group of 132 patients (149 hips) in whom primary total hip arthroplasty had been performed by one surgeon using a cemented collared femoral component with a polished (0.1-microm Ra) surface finish and a cementless acetabular component. Ninety-eight patients (115 hips) were followed for a minimum of ten years. We compared the survivorship of this prosthesis with that of a femoral component of similar design but with rougher surfaces (matte or grit-blasted).

RESULTS

No polished stems were revised because of aseptic loosening or demonstrated radiographic evidence of loosening; however, eight hips (5.4%) with a polished stem demonstrated osteolysis distal to the greater or lesser tro-chanter. In contrast, six stems (2.0%) with a matte surface finish of 0.8-microm Ra were revised because of aseptic loosening, and an additional five stems were seen to be loose radiographically. Eleven stems (9.2%) with a grit-blasted surface finish of 2.1-microm Ra were revised because of aseptic loosening, and an additional four stems were seen to be loose radiographically. The difference in the prevalence of revision due to aseptic loosening between the group with the 0.1-microm Ra surface and the group with the 2.1-microm Ra surface was significant (p = 0.001), as was the difference between the prevalence of revision due to aseptic loosening between the group with the 0.8-microm Ra surface and the group with the 2.1-microm Ra surface (p = 0.001). No cups were revised because of aseptic loosening, and one hip had radiographic signs of acetabular loosening.

CONCLUSIONS

This study demonstrated excellent durability of a prosthesis consisting of a cemented, collared, polished femoral component and a cementless acetabular component. While no hips were revised because of aseptic loosening, distal femoral osteolysis was observed in eight hips (5.4%), a higher prevalence than has been reported by others after similar durations of follow-up of tapered, collarless, polished femoral components.

Authors+Show Affiliations

Department of Orthopaedics, University of Iowa Health Care, 200 Hawkins Drive, Iowa City, IA 52242, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17200319

Citation

Firestone, Daniel E., et al. "Total Hip Arthroplasty With a Cemented, Polished, Collared Femoral Stem and a Cementless Acetabular Component. a Follow-up Study at a Minimum of Ten Years." The Journal of Bone and Joint Surgery. American Volume, vol. 89, no. 1, 2007, pp. 126-32.
Firestone DE, Callaghan JJ, Liu SS, et al. Total hip arthroplasty with a cemented, polished, collared femoral stem and a cementless acetabular component. A follow-up study at a minimum of ten years. J Bone Joint Surg Am. 2007;89(1):126-32.
Firestone, D. E., Callaghan, J. J., Liu, S. S., Goetz, D. D., Sullivan, P. M., Vittetoe, D. A., & Johnston, R. C. (2007). Total hip arthroplasty with a cemented, polished, collared femoral stem and a cementless acetabular component. A follow-up study at a minimum of ten years. The Journal of Bone and Joint Surgery. American Volume, 89(1), pp. 126-32.
Firestone DE, et al. Total Hip Arthroplasty With a Cemented, Polished, Collared Femoral Stem and a Cementless Acetabular Component. a Follow-up Study at a Minimum of Ten Years. J Bone Joint Surg Am. 2007;89(1):126-32. PubMed PMID: 17200319.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Total hip arthroplasty with a cemented, polished, collared femoral stem and a cementless acetabular component. A follow-up study at a minimum of ten years. AU - Firestone,Daniel E, AU - Callaghan,John J, AU - Liu,Steve S, AU - Goetz,Devon D, AU - Sullivan,Patrick M, AU - Vittetoe,David A, AU - Johnston,Richard C, PY - 2007/1/4/pubmed PY - 2007/2/23/medline PY - 2007/1/4/entrez SP - 126 EP - 32 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 89 IS - 1 N2 - BACKGROUND: Recent studies have suggested that cemented femoral components with a polished surface may provide superior long-term fixation when compared with femoral components with a roughened surface. The purpose of this study was to evaluate the results of total hip arthroplasty with a cemented femoral component with a polished surface finish and compare them with the results of total hip arthroplasty performed with a similar design of cemented femoral component with a rougher surface finish. METHODS: We retrospectively reviewed a consecutive group of 132 patients (149 hips) in whom primary total hip arthroplasty had been performed by one surgeon using a cemented collared femoral component with a polished (0.1-microm Ra) surface finish and a cementless acetabular component. Ninety-eight patients (115 hips) were followed for a minimum of ten years. We compared the survivorship of this prosthesis with that of a femoral component of similar design but with rougher surfaces (matte or grit-blasted). RESULTS: No polished stems were revised because of aseptic loosening or demonstrated radiographic evidence of loosening; however, eight hips (5.4%) with a polished stem demonstrated osteolysis distal to the greater or lesser tro-chanter. In contrast, six stems (2.0%) with a matte surface finish of 0.8-microm Ra were revised because of aseptic loosening, and an additional five stems were seen to be loose radiographically. Eleven stems (9.2%) with a grit-blasted surface finish of 2.1-microm Ra were revised because of aseptic loosening, and an additional four stems were seen to be loose radiographically. The difference in the prevalence of revision due to aseptic loosening between the group with the 0.1-microm Ra surface and the group with the 2.1-microm Ra surface was significant (p = 0.001), as was the difference between the prevalence of revision due to aseptic loosening between the group with the 0.8-microm Ra surface and the group with the 2.1-microm Ra surface (p = 0.001). No cups were revised because of aseptic loosening, and one hip had radiographic signs of acetabular loosening. CONCLUSIONS: This study demonstrated excellent durability of a prosthesis consisting of a cemented, collared, polished femoral component and a cementless acetabular component. While no hips were revised because of aseptic loosening, distal femoral osteolysis was observed in eight hips (5.4%), a higher prevalence than has been reported by others after similar durations of follow-up of tapered, collarless, polished femoral components. SN - 0021-9355 UR - https://www.unboundmedicine.com/medline/citation/17200319/Total_hip_arthroplasty_with_a_cemented_polished_collared_femoral_stem_and_a_cementless_acetabular_component__A_follow_up_study_at_a_minimum_of_ten_years_ L2 - http://Insights.ovid.com/pubmed?pmid=17200319 DB - PRIME DP - Unbound Medicine ER -