Effect of symmetrical restoration for the migration of uncemented total hip arthroplasty : A randomized RSA study with 75 patients and 5-year follow-up
Kiernan, Sverrir LU
; Geijer, Mats
LU
; Sundberg, Martin
LU
and Flivik, Gunnar
LU
(2020)
In Journal of Orthopaedic Surgery and Research
15(1).
- Abstract
Background: Inferior placement of a femoral stem is predictive for early loosening and failure, but does restoration of the original hip anatomy benefit the function and survival of a total hip replacement? Methods: Seventy-five patients with primary unilateral hip osteoarthritis operated with an uncemented anatomical stem were randomized for either standard or modular stems. We used 50 ABG II stems with modular necks and 25 standard stems (control group). We measured the symmetry in hip anatomy between healthy and operated side. The anatomical restoration variables were anteversion, global offset, and femoral offset/acetabular offset (FO/AO) quota. We performed measurements using a CT-based 3D templating and measuring software.... (More)
Background: Inferior placement of a femoral stem is predictive for early loosening and failure, but does restoration of the original hip anatomy benefit the function and survival of a total hip replacement? Methods: Seventy-five patients with primary unilateral hip osteoarthritis operated with an uncemented anatomical stem were randomized for either standard or modular stems. We used 50 ABG II stems with modular necks and 25 standard stems (control group). We measured the symmetry in hip anatomy between healthy and operated side. The anatomical restoration variables were anteversion, global offset, and femoral offset/acetabular offset (FO/AO) quota. We performed measurements using a CT-based 3D templating and measuring software. Migratory behavior of the stems was then measured postoperatively with repeated radiostereometry (RSA) examinations over 5 years. Results: Both stem types showed an early (within 3 months) good stabilization after an initial slight rotation into retroversion and subsidence. There were no significant differences in RSA migration between modular and standard stems. Postoperative anteversion and FO/AO quota had no impact on stem migration. The standard stem tended to result in insufficient global offset (GO), whereas the modular stem did not. Conclusions: The modular stem gave good symmetrical anatomical restoration and, like the standard version, a benign migratory behavior. Anteversion, GO, and FO/AO quota had no significant impact on stem migration. It therefore seems to be of no importance whether we choose a modular or a standard stem with regard to postoperative stem migration for this stem type. We overestimated the effect anatomical parameters have on stem movement; hence, we believe the study to be underpowered. Trial registration: ClinicalTrials.gov identifier: NCT01512550. Registered 19 January 2012 - retrospectively registered,
(Less)
- author
- Kiernan, Sverrir
LU
; Geijer, Mats
LU
; Sundberg, Martin
LU
and Flivik, Gunnar
LU
- organization
- publishing date
- 2020-06-17
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- 3D-CT, Anatomical restoration, Radiostereometry, RSA, THA, THR
- in
- Journal of Orthopaedic Surgery and Research
- volume
- 15
- issue
- 1
- article number
- 225
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85086692260
- pmid:32552711
- ISSN
- 1749-799X
- DOI
- 10.1186/s13018-020-01736-0
- language
- English
- LU publication?
- yes
- id
- 157a7d84-7a97-4d08-aebd-92c45101ee38
- date added to LUP
- 2020-07-08 08:30:13
- date last changed
- 2024-04-03 10:22:47
@article{157a7d84-7a97-4d08-aebd-92c45101ee38,
abstract = {{<p>Background: Inferior placement of a femoral stem is predictive for early loosening and failure, but does restoration of the original hip anatomy benefit the function and survival of a total hip replacement? Methods: Seventy-five patients with primary unilateral hip osteoarthritis operated with an uncemented anatomical stem were randomized for either standard or modular stems. We used 50 ABG II stems with modular necks and 25 standard stems (control group). We measured the symmetry in hip anatomy between healthy and operated side. The anatomical restoration variables were anteversion, global offset, and femoral offset/acetabular offset (FO/AO) quota. We performed measurements using a CT-based 3D templating and measuring software. Migratory behavior of the stems was then measured postoperatively with repeated radiostereometry (RSA) examinations over 5 years. Results: Both stem types showed an early (within 3 months) good stabilization after an initial slight rotation into retroversion and subsidence. There were no significant differences in RSA migration between modular and standard stems. Postoperative anteversion and FO/AO quota had no impact on stem migration. The standard stem tended to result in insufficient global offset (GO), whereas the modular stem did not. Conclusions: The modular stem gave good symmetrical anatomical restoration and, like the standard version, a benign migratory behavior. Anteversion, GO, and FO/AO quota had no significant impact on stem migration. It therefore seems to be of no importance whether we choose a modular or a standard stem with regard to postoperative stem migration for this stem type. We overestimated the effect anatomical parameters have on stem movement; hence, we believe the study to be underpowered. Trial registration: ClinicalTrials.gov identifier: NCT01512550. Registered 19 January 2012 - retrospectively registered,</p>}},
author = {{Kiernan, Sverrir and Geijer, Mats and Sundberg, Martin and Flivik, Gunnar}},
issn = {{1749-799X}},
keywords = {{3D-CT; Anatomical restoration; Radiostereometry; RSA; THA; THR}},
language = {{eng}},
month = {{06}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Journal of Orthopaedic Surgery and Research}},
title = {{Effect of symmetrical restoration for the migration of uncemented total hip arthroplasty : A randomized RSA study with 75 patients and 5-year follow-up}},
url = {{http://dx.doi.org/10.1186/s13018-020-01736-0}},
doi = {{10.1186/s13018-020-01736-0}},
volume = {{15}},
year = {{2020}},
}