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Stable migration pattern of an ultra-short anatomical uncemented hip stem : A prospective study with 2 years radiostereometric analysis follow-up

Mahmoud, Ahmed Nageeb LU ; Kesteris, Uldis LU and Flivik, Gunnar LU (2017) In HIP International 27(3). p.259-266
Abstract

Introduction: Shorter, anatomically shaped and proximally loading stems have been developed to achieve better stress distribution and be more bone preserving. The purpose of this prospective study was to evaluate the migration pattern of the Proxima™ ultra-short uncemented stem using radiostereometric analysis (RSA), and to review the literature regarding the migration of short stemmed hip arthroplasty. Methods: 25 patients (28 hips) with hip osteoarthritis received a Proxima stem during total hip arthroplasty (THA). To measure stem migration, repeated RSA examinations were done during a 2 year follow up period. The patients were evaluated with the hip specific (HOOS) and the generic health (EQ5D) scores up to 1 year, and clinically for... (More)

Introduction: Shorter, anatomically shaped and proximally loading stems have been developed to achieve better stress distribution and be more bone preserving. The purpose of this prospective study was to evaluate the migration pattern of the Proxima™ ultra-short uncemented stem using radiostereometric analysis (RSA), and to review the literature regarding the migration of short stemmed hip arthroplasty. Methods: 25 patients (28 hips) with hip osteoarthritis received a Proxima stem during total hip arthroplasty (THA). To measure stem migration, repeated RSA examinations were done during a 2 year follow up period. The patients were evaluated with the hip specific (HOOS) and the generic health (EQ5D) scores up to 1 year, and clinically for 6 years postoperatively. Results: Almost all migration occurred within the first 3 months, with mean subsidence of 0.22 mm and varus rotation of 1.04°, being the primary effect variables. After the third postoperative month and up to the 2 year RSA follow up no further significant migration occurred. The outcome scores showed substantial improvement after 1 year. No revisions were performed or indicated for any stem after a mean clinical follow up of 72.1 months. Conclusions: Like many other uncemented stems, the Proxima showed early migration up to 3 months hereafter osseointegration seems to have occurred. The achieved stability and clinical outcomes indicate favorable early results for this stem in younger patients who have good bone quality and average BMI. We found, however, the surgical technique to be slightly more demanding compared to conventional stems owing to the unique implant design that necessitates specific adjusted femoral cutting and broaching procedures.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Femoral component migration, Proxima, RSA, Short Femoral Stem, THA
in
HIP International
volume
27
issue
3
pages
8 pages
publisher
Wichtig Editore
external identifiers
  • scopus:85019941351
  • wos:000401634100010
ISSN
1120-7000
DOI
10.5301/hipint.5000458
language
English
LU publication?
yes
id
1c4a5ec0-05e5-4b74-9bcf-5edaa907246c
date added to LUP
2017-06-16 14:20:25
date last changed
2017-09-18 11:41:45
@article{1c4a5ec0-05e5-4b74-9bcf-5edaa907246c,
  abstract     = {<p>Introduction: Shorter, anatomically shaped and proximally loading stems have been developed to achieve better stress distribution and be more bone preserving. The purpose of this prospective study was to evaluate the migration pattern of the Proxima™ ultra-short uncemented stem using radiostereometric analysis (RSA), and to review the literature regarding the migration of short stemmed hip arthroplasty. Methods: 25 patients (28 hips) with hip osteoarthritis received a Proxima stem during total hip arthroplasty (THA). To measure stem migration, repeated RSA examinations were done during a 2 year follow up period. The patients were evaluated with the hip specific (HOOS) and the generic health (EQ5D) scores up to 1 year, and clinically for 6 years postoperatively. Results: Almost all migration occurred within the first 3 months, with mean subsidence of 0.22 mm and varus rotation of 1.04°, being the primary effect variables. After the third postoperative month and up to the 2 year RSA follow up no further significant migration occurred. The outcome scores showed substantial improvement after 1 year. No revisions were performed or indicated for any stem after a mean clinical follow up of 72.1 months. Conclusions: Like many other uncemented stems, the Proxima showed early migration up to 3 months hereafter osseointegration seems to have occurred. The achieved stability and clinical outcomes indicate favorable early results for this stem in younger patients who have good bone quality and average BMI. We found, however, the surgical technique to be slightly more demanding compared to conventional stems owing to the unique implant design that necessitates specific adjusted femoral cutting and broaching procedures.</p>},
  author       = {Mahmoud, Ahmed Nageeb and Kesteris, Uldis and Flivik, Gunnar},
  issn         = {1120-7000},
  keyword      = {Femoral component migration,Proxima,RSA,Short Femoral Stem,THA},
  language     = {eng},
  number       = {3},
  pages        = {259--266},
  publisher    = {Wichtig Editore},
  series       = {HIP International},
  title        = {Stable migration pattern of an ultra-short anatomical uncemented hip stem : A prospective study with 2 years radiostereometric analysis follow-up},
  url          = {http://dx.doi.org/10.5301/hipint.5000458},
  volume       = {27},
  year         = {2017},
}