Clinical and Radiographic Analysis of the CEMENTFREE® Uncemented Hip Stem of National Manufacture. Short-Term Results
Abstract
Introduction: The stability of the femoral component and its resistance to subsidence are critical factors to achieve correct osseointegration and subsequent clinical success in cementless total hip arthroplasty. Few studies have evaluated the results of nationally manufactured stems, even in the short and medium term. Our objective is to clinically and radiologically analyze patients undergoing a total hip replacement with a nationally manufactured femoral component (Cementfree® stem). Materials and Methods: We carried out a retrospective study on patients who had undergone a total hip replacement with the Cementfree® stem between January 2015 and August 2020 by the same surgeon and at the same institution. Results: 46 uncemented stems were implanted in 42 patients with an age range between 60 and 81 years. The average follow-up was 3 years, with a minimum of 1 year and a maximum of 5 years. There was an evident improvement in the Harris Hip Score (an average of 47 preoperatively vs. 93 after surgery). The revision of the stem for aseptic loosening, in the Kaplan Meier analysis, demonstrated a 100% survival rate at 5 years. Conclusion: According to the results obtained in this research, hip arthroplasty with the nationally manufactured Cementfree® stem has proven to be an option comparable to other imported stems in terms of short-term clinical and radiographic outcomes. An evaluation of the outcomes in the medium and long term is pending.Downloads
References
Müller LA, Wenger N, Schramm M, Hohmann D, Forst R, Carl H-D. Seventeen-year survival of the cementless
CLS Spotorno stem. Arch Orthop Trauma Surg 2010;130(2):269-75. https://doi.org/10.1007/s00402-009-0969-7
Kelsey D, Goodman SB. Design of the femoral component for cementless hip replacement: the surgeon’s
perspective. Am J Orthop (Belle Mead NJ) 1997;26:407-12. PMID: 9193693
Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH. Structural and cellular assessment of bone quality of proximal femur. Bone 1993;14(3):231-42. https://doi.org/10.1016/8756-3282(93)90146-2
Engh CA, Glassman AH. Cementless revision of failed total hip replacement: An update. Instruct Course Lect
;40:189-200.
Engh CA, Griffin WL, Marx CL. Cementless acetabular components. J Bone Joint Surg Br 1990;72:53-9.
https://doi.org/10.1302/0301-620X.72B1.2298795
Kärrholm J, Herberts P, Hultmark P, Malchau H, Nivbrant B, Thanner J. Radiostereometry of hip prostheses: review of methodology and clinical results. Clin Orthop Rel Res 1997;(344):94-110. PMID: 937276
Harris WH. Optimization of bone ingrowth for fixation of total hip replacements. En: Lin OCC, Chao EYS.
Perspectives on Biomaterials. Materials Science Monographs, 34th ed. Amsterdam: Elsevier: 1986:321-32.
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg Am 1969;51:737-45. https://doi.org/10.1007/978-1-4471-5451-8_3
Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement: the factors governing bone in growth, stress shielding and clinical results. J Bone Joint Surg Br 1987;69:45-55. https://doi.org/10.1302/0301-620X.69B1.3818732
Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral component. Clin Orthop Relat Res 1990;(257):107-28. PMID: 2199114
Singh M, Magrath AR, Maini PS. Changes in trabecular pattern of upper end of the femur as an index of
osteoporosis. J Bone Joint Surg Am 1970;52(3):457-567. PMID: 5425640
Cameron HU, Pilliar R. The effect of movement on the bonding of porous metal to bone. J Biomed Mater Res
;7(4):301-11. https://doi.org/10.1002/jbm.820070404
Persigan VA. Molecular forces governing tight contact between cellular surfaces and substrates, J. Prosth Dent 1983;49(6):838-46. https://doi.org/10.1016/0022-3913(83)90360-8
Freeman MA, Plante-Bordeneuve P. Early migration and late aseptic failure of proximal femoral prostheses. J Bone Joint Surg Br 1994;76(3):432-8. https://doi.org/10.1302/0301-620X.76B3.8175848
McTighe T, Stulberg SD, Keppler L, Keggi J, Kennon RT, Brazil D, et al. A classification system for short stem
uncemented THA. Poster #4. International Congress for Joint Reconstruction, 2012. Disponible en:
http://www.jisrf.org/pdfs/a-classi_cation-system-short-stem.pdf
Rodríguez Sammartino G. Fracturas del tallo femoral en artroplastia total de cadera híbrida. Reporte de dos
casos clínicos evaluados con análisis de falla de materiales. Revista ACARO 2015;1(1). Disponible en:
https://acarorevista.org.ar/joomla-pages-iii/categories-list/40-la-revista/ediciones-anteriores/abril-2015-vol-1-num-1/99-fracturas-del-tallo-femoral-en-artroplastia-total-de-cadera-hibrida-reporte-de-dos-casos-clinicos-evaluados-conanalisis-de-falla-de-materiales
Köksal A, Öner A, Çimen O, Aycan OE, Akgün H, Yapici F, et al. Femoral stem fractures after primary and revision hip replacements: A single-center experience. Jt Dis Relat Surg 2020;31(3):557-63. https://doi:10.5606/ehc.2020.76162
Simesen de Bielke H, Pérez Alamino L, Garabano G, Pesciallo CÁ, del Sel H, Lopreite FA. Comportamiento de los tallos no cementados recubiertos con hidroxiapatita colocados con alineación coronal inadecuada en la artroplastia primaria de cadera. Resultados del seguimiento a largo plazo. Rev Asoc Argent Ortop Traumatol 2021;86(4):455-62. https://doi.org/10.15417/issn.1852-7434.2021.86.4.1321
Perea AO, Spesot P, García M, Arce J, García S, Munafó Ducia R. Análisis clínico-radiológico comparativo de
tallos femorales no cementados planos de primera vs. segunda generación. Rev Asoc Argent Ortop Traumatol
;86(4):475-82. https://doi.org/10.15417/issn.1852-7434.2021.86.4.1337
Bochatey EJ, Lopreite FA. Resultados a corto plazo de la artroplastia total de cadera con tallos femorales de fijación metafisaria de segunda generación. Rev Asoc Argent Ortop Traumatol 2020;85(3):214-21. https://doi.org/10.15417/issn.1852-7434.2020.85.3.1021
Colacchio N, Robbins C, Aghazadeh M, Talmo C, Bono J. Total hip intraoperative femur fracture: does a tapered wedge design with a size specific medial curvature reduce the incidence of intraoperative femur fracture? J Arthroplasty 2017;32(10):31638. https://doi.org/10.1016/j.arth.2017.05.012
Steens W, Skripitz R, Schneeberger AG, Petzing I, Simon U, Goetze C. [Cementless femoral neck prosthesis CUT--clinical and radiological results after 5 years]. Z Orthop Unfall 2010;148(4):413–9. https://doi.org/10.1055/s-0030-1250150 [En alemán]
Santori FS, Santori N. Mid-term results of a custom-made short proximal loading femoral component. J Bone Joint Surg Br 2010;92(9):1231-7. https://doi.org/10.1302/0301-620X.92B9.24605
Kim YH, Kim JS, Joo JH, Park JW. A prospective short-term outcome study of a short metaphyseal fitting total hip arthroplasty. J Arthroplasty 2012;27(1):88. https://doi.org/10.1016/j.arth.2011.02.008
Cornell CN, Ranawat CS. Survivorship analysis of total hip replacements. J Bone Joint Surg Am 1986;68(9):1430-7. PMID: 3782214
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
