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Long-term outcome of cemented total hip arthroplasty with the Charnley-type femoral stem made of titanium alloy.

Abstract

BACKGROUND

Total hip arthroplasty is a successful treatment for hip diseases including osteoarthritis, osteonecrosis of the femoral head, and rheumatoid arthritis. Various designs of cemented femoral stems made of stainless steel and titanium alloy have been used. Among them, Charnley-type femoral stems made of stainless steel have often been reported to have good long-term outcome. However, the long-term outcome of the Charnley-type femoral stem made of Ti alloy is yet to be reported. We conducted a retrospective study to assess the long-term outcome of cemented primary total hip arthroplasty with the Charnley-type femoral stem made of Ti alloy.

METHODS

Between October 1988 and February 1997, 341 cemented primary total hip arthroplasties with the Charnley-type femoral stem made of Ti alloy were consecutively performed in our hospital. Among these, 164 patients (211 hips) who underwent this procedure were followed up for more than 12 years, and the surgical hips were analysed clinically and radiologically. The mean follow-up period was 20.6 years. Kaplan-Meier survival analyses were performed to assess femoral component survival. Factors affecting stem revision for aseptic loosening were also investigated using log-rank tests.

RESULTS

In the functional assessment, the preoperative Japanese Orthopaedic Association score significantly improved from 47.2 points preoperatively to 79.0 points at the final follow-up. Eventually, 33 femoral stems were revised, of which 12 were revised for aseptic loosening. In the Kaplan-Meier survival analysis, the 20-year survival rates with stem revision for aseptic loosening and radiological stem loosening at the end points were 95.9% and 97.1%, respectively. Original diagnosis (non-osteoarthritis) was the only significant factor for aseptic loosening of the femoral stem.

CONCLUSIONS

Cemented primary total hip arthroplasty with the Charnley-type femoral stem made of Ti alloy showed excellent outcomes for more than 20 years.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan. Electronic address: k.g.bau@kuhp.kyoto-u.ac.jp.Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31422864

Citation

Okutani, Yuki, et al. "Long-term Outcome of Cemented Total Hip Arthroplasty With the Charnley-type Femoral Stem Made of Titanium Alloy." Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association, 2019.
Okutani Y, Goto K, Kuroda Y, et al. Long-term outcome of cemented total hip arthroplasty with the Charnley-type femoral stem made of titanium alloy. J Orthop Sci. 2019.
Okutani, Y., Goto, K., Kuroda, Y., Kawai, T., Okuzu, Y., Kawata, T., ... Matsuda, S. (2019). Long-term outcome of cemented total hip arthroplasty with the Charnley-type femoral stem made of titanium alloy. Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association, doi:10.1016/j.jos.2019.07.013.
Okutani Y, et al. Long-term Outcome of Cemented Total Hip Arthroplasty With the Charnley-type Femoral Stem Made of Titanium Alloy. J Orthop Sci. 2019 Aug 16; PubMed PMID: 31422864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcome of cemented total hip arthroplasty with the Charnley-type femoral stem made of titanium alloy. AU - Okutani,Yuki, AU - Goto,Koji, AU - Kuroda,Yutaka, AU - Kawai,Toshiyuki, AU - Okuzu,Yaichiro, AU - Kawata,Tomotoshi, AU - Shimizu,Yu, AU - Matsuda,Shuichi, Y1 - 2019/08/16/ PY - 2019/02/08/received PY - 2019/07/16/revised PY - 2019/07/19/accepted PY - 2019/8/20/entrez JF - Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association JO - J Orthop Sci N2 - BACKGROUND: Total hip arthroplasty is a successful treatment for hip diseases including osteoarthritis, osteonecrosis of the femoral head, and rheumatoid arthritis. Various designs of cemented femoral stems made of stainless steel and titanium alloy have been used. Among them, Charnley-type femoral stems made of stainless steel have often been reported to have good long-term outcome. However, the long-term outcome of the Charnley-type femoral stem made of Ti alloy is yet to be reported. We conducted a retrospective study to assess the long-term outcome of cemented primary total hip arthroplasty with the Charnley-type femoral stem made of Ti alloy. METHODS: Between October 1988 and February 1997, 341 cemented primary total hip arthroplasties with the Charnley-type femoral stem made of Ti alloy were consecutively performed in our hospital. Among these, 164 patients (211 hips) who underwent this procedure were followed up for more than 12 years, and the surgical hips were analysed clinically and radiologically. The mean follow-up period was 20.6 years. Kaplan-Meier survival analyses were performed to assess femoral component survival. Factors affecting stem revision for aseptic loosening were also investigated using log-rank tests. RESULTS: In the functional assessment, the preoperative Japanese Orthopaedic Association score significantly improved from 47.2 points preoperatively to 79.0 points at the final follow-up. Eventually, 33 femoral stems were revised, of which 12 were revised for aseptic loosening. In the Kaplan-Meier survival analysis, the 20-year survival rates with stem revision for aseptic loosening and radiological stem loosening at the end points were 95.9% and 97.1%, respectively. Original diagnosis (non-osteoarthritis) was the only significant factor for aseptic loosening of the femoral stem. CONCLUSIONS: Cemented primary total hip arthroplasty with the Charnley-type femoral stem made of Ti alloy showed excellent outcomes for more than 20 years. SN - 1436-2023 UR - https://www.unboundmedicine.com/medline/citation/31422864/Long-term_outcome_of_cemented_total_hip_arthroplasty_with_the_Charnley-type_femoral_stem_made_of_titanium_alloy L2 - https://linkinghub.elsevier.com/retrieve/pii/S0949-2658(19)30242-8 DB - PRIME DP - Unbound Medicine ER -