Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty
Abstract Purpose Although a cementless modular prosthesis has shown reliable results, cases of unstable fixation and revision due to aseptic loosening were observed in our institute. The purpose of this study was to clarify the causes of unstable fixation of the prosthesis. Methods A total of 144 pa...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-11-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-020-02101-x |
| _version_ | 1818475018554703872 |
|---|---|
| author | Kyosuke Kobayashi Kenichi Kidera Masaru Itose Tetsuhiko Motokawa Ko Chiba Makoto Osaki |
| author_facet | Kyosuke Kobayashi Kenichi Kidera Masaru Itose Tetsuhiko Motokawa Ko Chiba Makoto Osaki |
| author_sort | Kyosuke Kobayashi |
| collection | DOAJ |
| description | Abstract Purpose Although a cementless modular prosthesis has shown reliable results, cases of unstable fixation and revision due to aseptic loosening were observed in our institute. The purpose of this study was to clarify the causes of unstable fixation of the prosthesis. Methods A total of 144 patients (154 hips) who underwent total hip arthroplasty using the modular prosthesis were retrospectively investigated. For the cohort study, 97 patients (104 hips) were included. The femoral component survival rate and sleeve fixation were assessed at a minimum follow-up of 5 years. Patients were divided into 2 groups, including stable and unstable fixation groups, by sleeve fixation. Clinical and radiographic outcomes were compared. Results The Kaplan-Meier survival rate at 9 years was 93% with revision for any reason as the endpoint in study cohort. The reasons for revision were recurrent dislocation (1 hip) and aseptic loosening of the stem (5 hips). A total of 88 hips (84.6%) showed stable fixation, and 16 hips (15.4%) showed unstable fixation at final follow-up. There was no significant difference in clinical outcomes between the 2 groups at final follow-up. The canal flare index was significantly higher, and the canal filling ratio was significantly lower in the unstable fixation group. Conclusion Although the modified modular prosthesis was useful for treating anatomically difficult patients, we need to pay attention to both proximal/distal mismatch of the intramedullary canal and the canal filling ratio to achieve stable fixation and good long-term results. |
| first_indexed | 2024-04-14T04:44:01Z |
| format | Article |
| id | doaj.art-d0f5d73067ab44aa9d295c4fd169157e |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T04:44:01Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-d0f5d73067ab44aa9d295c4fd169157e2022-12-22T02:11:31ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-11-011511910.1186/s13018-020-02101-xHigher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplastyKyosuke Kobayashi0Kenichi Kidera1Masaru Itose2Tetsuhiko Motokawa3Ko Chiba4Makoto Osaki5Nagasaki University HospitalNagasaki University HospitalNagasaki University HospitalNagasaki University HospitalNagasaki University HospitalNagasaki University HospitalAbstract Purpose Although a cementless modular prosthesis has shown reliable results, cases of unstable fixation and revision due to aseptic loosening were observed in our institute. The purpose of this study was to clarify the causes of unstable fixation of the prosthesis. Methods A total of 144 patients (154 hips) who underwent total hip arthroplasty using the modular prosthesis were retrospectively investigated. For the cohort study, 97 patients (104 hips) were included. The femoral component survival rate and sleeve fixation were assessed at a minimum follow-up of 5 years. Patients were divided into 2 groups, including stable and unstable fixation groups, by sleeve fixation. Clinical and radiographic outcomes were compared. Results The Kaplan-Meier survival rate at 9 years was 93% with revision for any reason as the endpoint in study cohort. The reasons for revision were recurrent dislocation (1 hip) and aseptic loosening of the stem (5 hips). A total of 88 hips (84.6%) showed stable fixation, and 16 hips (15.4%) showed unstable fixation at final follow-up. There was no significant difference in clinical outcomes between the 2 groups at final follow-up. The canal flare index was significantly higher, and the canal filling ratio was significantly lower in the unstable fixation group. Conclusion Although the modified modular prosthesis was useful for treating anatomically difficult patients, we need to pay attention to both proximal/distal mismatch of the intramedullary canal and the canal filling ratio to achieve stable fixation and good long-term results.https://doi.org/10.1186/s13018-020-02101-xTHAModular prosthesisAseptic looseningCanal filling ratio |
| spellingShingle | Kyosuke Kobayashi Kenichi Kidera Masaru Itose Tetsuhiko Motokawa Ko Chiba Makoto Osaki Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty Journal of Orthopaedic Surgery and Research THA Modular prosthesis Aseptic loosening Canal filling ratio |
| title | Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty |
| title_full | Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty |
| title_fullStr | Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty |
| title_full_unstemmed | Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty |
| title_short | Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty |
| title_sort | higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty |
| topic | THA Modular prosthesis Aseptic loosening Canal filling ratio |
| url | https://doi.org/10.1186/s13018-020-02101-x |
| work_keys_str_mv | AT kyosukekobayashi higherincidenceofasepticlooseningcausedbyalowercanalfillingratiowithamodifiedmodularstemintotalhiparthroplasty AT kenichikidera higherincidenceofasepticlooseningcausedbyalowercanalfillingratiowithamodifiedmodularstemintotalhiparthroplasty AT masaruitose higherincidenceofasepticlooseningcausedbyalowercanalfillingratiowithamodifiedmodularstemintotalhiparthroplasty AT tetsuhikomotokawa higherincidenceofasepticlooseningcausedbyalowercanalfillingratiowithamodifiedmodularstemintotalhiparthroplasty AT kochiba higherincidenceofasepticlooseningcausedbyalowercanalfillingratiowithamodifiedmodularstemintotalhiparthroplasty AT makotoosaki higherincidenceofasepticlooseningcausedbyalowercanalfillingratiowithamodifiedmodularstemintotalhiparthroplasty |