Risk factors for aseptic loosening of Müller-type straight stems.
Background and purpose Even small differences in design variables for the femoral stem may influence the outcome of a hip arthroplasty. We performed a risk factor analysis for aseptic loosening of 4 different versions of cemented Müller-type straight stems with special emphasis on design modificatio...
| Publicado en: | Acta Orthopaedica Vol. 84; no. 4; pp. 353 - 360 |
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| Autores principales: | , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Aug2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=90055893&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 90055893 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Aug2013 vid: 84 iid: 4 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 90055893 104092490 104092490 10.3109/17453674.2013.810517 90055893 ppf: 353 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Risk factors for aseptic loosening of Müller-type straight stems. aug: au: Clauss, Martin Gersbach, Silke Butscher, Andre Ilchmann, Thomas affil: Clinic for Orthopedic and Trauma Surgery, Kantonsspital Baselland Liestal sug: subj: Arthroplasty, Replacement, Hip Methods Joint Prosthesis Statistics and Numerical Data Prosthesis Design Statistics and Numerical Data Prosthesis Failure Human Arthroplasty, Replacement, Hip Adverse Effects Arthroplasty, Replacement, Hip Equipment and Supplies Prospective Studies Male Female Registries, Disease Risk Assessment Risk Factors Treatment Outcomes Cox Proportional Hazards Model Regression Confidence Intervals Relative Risk Survival Analysis Kaplan-Meier Estimator Log-Rank Test Data Analysis Software Descriptive Statistics Aged Aged: 65+ years Male Female ab: Background and purpose Even small differences in design variables for the femoral stem may influence the outcome of a hip arthroplasty. We performed a risk factor analysis for aseptic loosening of 4 different versions of cemented Müller-type straight stems with special emphasis on design modifications (2 shapes, MSS or SL, and 2 materials, CoNiCrMo (Co) or Ti-6Al-7Nb (Ti)). Methods We investigated 828 total hip replacements, which were followed prospectively in our in-house register. All stems were operated in the same setup, using Sulfix-6 bone cement and a second-generation cementing technique. Demographic and design-specific risk factors were analyzed using an adjusted Cox regression model. Results The 4 versions showed marked differences in 15-year stem survival with aseptic loosening as the endpoint: 94% (95% CI: 89-99) for MSS Co, 83% (CI: 75-91) for SL Co, 81% (CI: 76-87) for MSS Ti and 63% (CI: 56-71) for SL Ti. Cox regression analysis showed a relative risk (RR) for aseptic loosening of 3 (CI: 2-5) for stems made of Ti and of 2 (CI: 1-2) for the SL design. The RR for aseptic stem loosening increased to 8 (CI: 4-15) when comparing the most and the least successful designs (MSS Co and SL Ti). Interpretation Cemented Müller-type straight stems should be MSS-shaped and made of a material with high flexural strength (e.g. cobalt-chrome). The surface finish should be polished (Ra < 0.4 µm). These technical aspects combined with modern cementing techniques would improve the survival of Müller-type straight stems. This may be true for all types of cemented stems. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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