Failure of the Uncoated Titanium ProxiLock Femoral Hip Prosthesis (original) (raw)
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Letters to the Editor: Failure of the Uncoated Titanium ProxiLock Femoral Hip Prosthesis
Clinical Orthopaedics and Related Research, 2007
New prostheses should be evaluated for stability and clinical performance. In a prospective randomized clinical trial, we implanted 22 titanium (Ti) and 20 hydroxyapatite-coated (HA) ProxiLock femoral hip prostheses during total hip arthroplasty in 42 patients. The patients were followed for 24 months with clinical, radiographic and radiostereometric analysis. Full weightbearing was allowed immediately postoperatively. One patient with a titanium stem was lost to followup. During the first two months, 34 of the 41 stems subsided and/or rotated towards retroversion, regardless of stem type. At the 24-month followup 35 of the 41 prostheses were either fully stabilized (16 HA and 11 Ti stems) or had clinical irrelevant migration (four HA and four Ti stems). Six Ti prostheses showed continuous migrations with maximums of 4.7 mm translation and 12.2°retroversion; four of these were revised, the other two had no clinical complaints. Clinical relevance: The migration pattern we found indicates insufficient primary fixation of the ProxiLock stem in an immediate full weightbearing protocol. The HA coating improves the secondary stability of the prosthesis compared to the uncoated stem. Early migration is associated with an increased risk of possible future loosening and revision, and therefore we discontinued the use of this prosthesis.
Clinics in Orthopedic Surgery, 2010
Background: Aseptic loosening of cemented hip prostheses is recognized as a long-term problem, and especially in males and younger patients. Much energy has been focused on developing new prostheses that are designed for cementless fixation. We evaluated the performance of and periprosthetic bone response to a tapered, titanium, hydroxyapatite (HA)-coated femoral hip prosthesis at a minimum of 7 years of follow-up after treatment with primary total hip arthroplasty.
Migration of hydroxyapatite coated femoral prostheses. A Roentgen Stereophotogrammetric study
The Journal of Bone and Joint Surgery. British volume, 1993
We allocated randomly 27 patients undergoing 28 primary uncemented total hip replacements (THR) to receive prosthetic components of similar design with either plasma-sprayed titanium alloy (Ti) coating (n = 13) or hydroxyapatite (HA) coating (n = 15). After some exclusions, 15 of the patients (15 THR; 7 with HA- and 8 with Ti-coating) were followed by roentgen stereophotogrammetric analysis at 3, 6 and 12 months to measure migration of the femoral component. Twenty-six of the patients (26 THR) were followed clinically and by conventional radiography. All the femoral components had migrated at 3 months. From 3 to 12 months, the migration of Ti-coated components continued whereas the HA-coated components had stabilised. At 12 months there was significantly less migration of the HA-coated components (p < 0.05). The maximum subsidence was 0.2 mm in both groups. The Harris hip score was equal in the two groups preoperatively but at follow-up it was better in the HA-coated group (p <...
Ten-year follow-up of an anatomical hydroxyapatite-coated total hip prosthesis
International Orthopaedics, 2006
We report our results after ten year follow-up of 107 consecutive ABG-I hip prostheses implanted between June 1990 and December 1992: Only 84 prostheses were still in the study after ten years, but only six patients had undergone surgical revision. We can consider our clinical outcomes as excellent, with a whole-implant survival rate greater than 96%, a mean Merle D'Aubigne and Postel score increasing from 7.97 before operation to 16.17 at ten year follow-up, and a personal subjective assessment as excellent or good in 82.14% of patients. However, radiographic outcomes are more worrying: around 90% of patients show a stress-shielding phenomenon and granulomatous lesions in the proximal femur, and more than 82% suffer polyethylene wear greater than one millimetre (mean 1.68 mm). We think that zirconia stem heads and hooded antiluxation PE inserts are determining factors in the process of PE wear and, secondarily, in cancellous bone resorption and bone osteolysis.
European journal of orthopaedic surgery & traumatology : orthopédie traumatologie, 2014
Registries in both the United Kingdom and Sweden suggest that the popularity of uncemented femoral components is increasing. As this trend progresses, long-term survival data for such components are becoming increasingly more important. We present the results of a cohort of patients treated with the Omnifit (Stryker, Mahwah, NJ) femoral component with the follow-up of 10-15 years. A prospective study was performed in our unit between 1996 and 2001. Patients were reviewed pre-operatively and then at 6, 12, 26 and 52 weeks post-operatively and annually thereafter. They were assessed clinically and radiographically, and the Merle d'Aubigne Postel (MDP) hip score was calculated at each visit. A visual analogue scale (VAS) score and satisfaction score were also recorded to assess patient satisfaction with their procedure. Specific enquiry was made regarding anterior thigh pain. Statistical calculations were performed using the Student's t test. Kaplan-Meier survival analysis was ...
Hydroxyapatite coated hip prosthesis followed up for 5 years
International Orthopaedics, 2001
We prospectively studied 250 patients with a proximal hydroxyapatite coated hip prosthesis. The follow-up period was 5 years. All components showed osseointegration except for one deep infection. The morphology of bone remodeling with either endosteal bone formation or periosteal bone formation was dependent on the way the stem filled the medullary canal. No linear or distal osteolysis around the stems was observed. Résumé 250 patients avec une prothèse de la hanche revêtue d' hydroxyapatite ont été étudiés avec un suivi de 5 années. Tous les composants ont montré une ostéointégration à l'exception d'un cas avec une infection profonde. La formation osseuse endostée ou periostée était dépendante du remplissage du canal médullaire par la tige. Aucune ostéolyse autour des tiges n'a été observée.
Clinical experiences with a titanium alloy total hip prosthesis: a posterior approach
PubMed, 1979
Using a titanium alloy femoral prosthesis (STH Zimmer) and an ultra high molecular weight polyethylene acetabular cup with a posterior surgical approach to the hip joint, 237 consecutive total hip arthroplasties in 215 patients were performed between December 1975 and May 1977. The preliminary results and early postoperative complications suggest that this system can be considered an alternative to total hip arthroplasty using other materials and surgical approaches.
2014
Background: The effect of hydroxyapatite (HA) coating on the fixation of a cementless femoral stem is discussed, in particular in cases of primary fixation with geometrically stable components. Therefore, we performed a comparative retrospective study of a series of Alloclassic-SL TM stems to: 1) present the long-term results and 2) evaluate the contribution, if any, of proximal HA coating. Hypotheses: Long-term cementless press-fit ("flat wedge-shaped") fixation is reliable and HA coating only improves the radiological results of the proximal bone-prosthesis interface. Materials and Methods: One hundred and ninety-eight Alloclassic total hip arthroplasties were performed in 179 patients, mean age 66 years old (22-85), including 105 with proximal HA coating and 93 with the original grit-blast coating. One hundred and ninety-three hips were analyzed after a mean follow-up of 9.8 years (1-24 years). Results: Results were excellent or good in 184 hips (95%) with no significant difference between the 2 groups (Merle d'Aubigné ≥ 16 for 89/92 (98%) without HA compared to 95/101 (94%) with HA P = 0.59). Radiographic signs of stable osseointegration were observed in 173 hips (90% of the cases). HA coating significantly improved the radiographic results of the proximal bone-implant interface: (42/92 (46%) of the stems without HA had proximal radiolucencies in zones 1 and 7 compared to 4/101 (4%) with HA (P = 0.0001)). Polyethylene wear > 0.1 mm/year was observed in 6 hips (3%) including 1/101 (1%) in the group with HA versus 5/92 (5.4%) without HA (P = 0.17). One intra-operative femoral fracture occurred and there were 9 dislocations in the first 3 postoperative months (4.5%). The main cause of revision surgery was recurrent dislocation (11/17 cases). The "revision per-100 observed-femoral component years" was 0.10 in both groups and survival for aseptic loosening of the stem was 100% (95% CI = 73.2% to 100%) at 20 years. Conclusion: This study shows that secondary fixation by osseointegration of a straight standard gritblasted titanium alloy non-anatomical implant is reliable. Possible proximal fibrous encapsulation, which is reduced by HA coating, but especially conventional polyethylene wear, were the main limitations of this system. Level of evidence: III retrospective case-control study.
Fixation and metal release from the Tifit femoral stem prosthesis: 5-year follow-up of 64 cases
Acta Orthopaedica, 1998
64 hips (60 patients) with primary or secondary arthrosis of the hip were studied. There were 28 men and 32 women with a median age of 55 (38-66) years. The fixation of the femoral stem was stratified into cemented fixation (C, n20), proximal HA coating (HA, n 23) or proximal porous coating (P, n 21) of the stem, based on age, gender, weight, radiographic Copyright 0 Scandinavian University Press 1998. ISSN 00014470. Printed in Sweden -all rights reserved. Acta Orthop Downloaded from informahealthcare.com by 223.87.83.148 on 05/20/14 For personal use only. (0,<50,50-99, 100%) 5 (0-30) 0-25d 9 (0-60) 0-59 5, 7, 1. 6 14, 2, 2, 1 16, 2, 0. 1 18, 0, 1, 0 16, 2, 1, 0 14, 2, 3, 0 8, 4, 4, 3 13, 5, 1 not measured 11, 5, 0, 3 9 (0-29) 0-30 31 (10-70) 0-78 7 (0-31) 0-24 38 (9-72) 2-73 19, 3, 1, 0 19, 4, 0, 0 22, 0, 1, 0 9, 3, 5, 6 20, 2, 1, 0 16, 7, 0, 0 20,
Long-Term Outcomes of a New Model of Anatomical Hydroxyapatite-Coated Hip Prosthesis
2012
This prospective study was designed to evaluate 196 Anatomique Benoist Giraud (ABG II) total hip arthroplasties which were implanted between September 1999 and December 2000. A minimum 11 years follow up was completed in 183 cases. The bearing surfaces were polyethylene-zirconia in 84 cases, polyethylene-metal in 42 and ceramic-ceramic in 57. Changes in the femoral stem design, in relation to the previous ABG I model, have led to a significant improvement in stress-shielding. Polyethylene wear rate was lower by more than 50% compared with non-crosslinked polyethylene. Excellent and good results were obtained in 90.32% of cases, and implant survival was 98.39% at the end of follow-up.