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Thursday, March 16, 2000

Cementless femoral fixation achieves excellent results

Cementless femoral fixation in the rheumatoid population at long-term follow up has been shown to achieve excellent results.

Researchers of poster exhibit 67 said bone ingrowth was consistently achieved, suggesting no adverse effect of varying bone quality in the rheumatoid patient. In the study, there were no femoral revisions and stable bone growth was achieved in 100 percent of patients. Thigh pain was present in only one patient. "The utilization of cementless total hip arthroplasty in the rheumatoid population may provide a theoretical advantage of a dynamic living bone-prosthesis interface that enables the junction to adapt to the metabolic changes that occur with rheumatoid bone rather than the degrading quality of the acrylic cement-bone interface that occurs with time," said Fabio Orozco, MD.

The study by Dr. Orozco and colleagues at the Rothman Institute, Philadelphia involved 45 total hip arthroplasties performed in 34 patients during January 1987 and November 1992; they were reviewed with a minimum five-year follow up (mean 8.03 years; range, 5 to 12.12 years). The 10 men and 24 women had a mean age of 54 years (31-77 years), and mean weight of 148 pounds (93-210 pounds). Preoperative diagnoses was rheumatoid arthritis in all patients.

Tapered, collarless, porous coated, titanium alloy femoral component and titanium, porous coated hemispherical acetabular component were used in all cases.

The Charnley scores for pain, function and motion improved from preoperative mean values of 2.2, 3.1 and 3.0 to 5.7, 5.5 and 5.3, respectively. The follow-up mean Harris Hip Score was 91.4 Thigh pain was present in only one patient (2.2 percent).

No femoral fractures occurred intraoperatively with the insertion of the prosthesis. No femoral components demonstrated evidence of radiographic loosening or required revision for aseptic loosening or incapacitating thigh pain. In addition, stable bone fixation was identified in 100 percent of the femoral components. Seven acetabular revisions were performed for loosening and eccentric wear.

Participating with Dr. Orozco at the Rothman Institute were Kjell Keisu, MD; William J. Hozack, MD; Peter F. Sharkey, MD; and Richard H. Rothman, MD, PhD.

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2000 Academy News March 16 Index B

Last modified 06/March/2000 by IS