Top

International Orthopaedics

Published in:

01-01-2017 | Original Paper

One-stage bilateral versus unilateral short-stem total hip arthroplasty: comparison of migration patterns using “Ein-Bild-Roentgen-Analysis Femoral-Component-Analysis”

Authors: Karl Philipp Kutzner, Tobias Freitag, Mark-Predg Kovacevis, Dominik Pfeil, Heiko Reichel, Ralf Bieger

Published in: International Orthopaedics | Issue 1/2017

Abstract

Purpose

The hypothesis of this study was that femoral implant migration would not differ between simultaneous bilateral or unilateral short-stem THA.

Method

Implant migration of 202 femoral short-stems (100 unilateral and 102 one-stage bilateral cases) in 151 patients was assessed by “Ein-Bild-Roentgen-Analysis Femoral-Component-Analysis” in a two years follow-up (2.0-3.0 years). Migration patterns of unilateral and simultaneous cases were analysed and compared.

Results

There was no difference between the two groups regarding age, body mass index and gender. After two years mean subsidence of all 202 implants was 1.43 mm (-6.5 mm to 2.0 mm). After initial subsidence of 0.37 mm per month within the first six weeks, the mean monthly migration was reduced to 0.02 mm between one and two years post-operative. There was no statistical difference in mean migration between unilateral (1.34 mm) and simultaneous bilateral (1.51 mm) THA (p = 0.33).

Conclusion

In summary, two years post-operative there was no difference in the amount of mean implant subsidence between unilateral compared to simultaneous bilateral short-stem THA. This suggests that regarding implant fixation simultaneous bilateral short-stem THA is as safe and successful as a solely unilateral intervention.

Garland A, Rolfson O, Garellick G, Karrholm J, Hailer NP (2015) Early postoperative mortality after simultaneous or staged bilateral primary total hip arthroplasty: an observational register study from the Swedish hip arthroplasty register. BMC Musculoskelet Disord 16(8):77. doi:10.1186/s12891-015-0535-0 CrossRefPubMedPubMedCentral

Kim YH, Kwon OR, Kim JS (2009) Is one-stage bilateral sequential total hip replacement as safe as unilateral total hip replacement? J Bone Joint Surg (Br) 91(3):316–320. doi:10.1302/0301-620X.91B3.21817 CrossRef

Stavrakis AI, SooHoo NF, Lieberman JR (2015) Bilateral total hip arthroplasty has similar complication rates to unilateral total hip arthroplasty. J Arthroplasty 30(7):1211–1214. doi:10.1016/j.arth.2015.02.015 CrossRefPubMed

Pfeil J, Hohle P, Rehbein P (2011) Bilateral endoprosthetic total hip or knee arthroplasty. Dtsch Arztebl Int 108(27):463–468. doi:10.3238/arztebl.2011.0463 PubMedPubMedCentral

Lamo-Espinosa J, Troncoso S, Valenti-Azcarate A, Diaz de Rada P, Valenti-Nin JR (2015) Clinical and radiological short-term complications after single-stage bilateral uncemented total hip arthroplasty. Musculoskelet Surg 99(1):67–73. doi:10.1007/s12306-014-0342-z CrossRefPubMed

Rao RR, Sharkey PF, Hozack WJ, Eng K, Rothman RH (1998) Immediate weightbearing after uncemented total hip arthroplasty. Clin Orthop Relat Res 349:156–162CrossRef

Krismer M, Biedermann R, Stockl B, Fischer M, Bauer R, Haid C (1999) The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-Analyse-femoral component analysis. J Bone Joint Surg (Br) 81(2):273–280CrossRef

Wolf O, Mattsson P, Milbrink J, Larsson S, Mallmin H (2010) Periprosthetic bone mineral density and fixation of the uncemented CLS stem related to different weight bearing regimes: a randomized study using DXA and RSA in 38 patients followed for 5 years. Acta Orthop 81(3):286–291. doi:10.3109/17453674.2010.487238 CrossRefPubMedPubMedCentral

Falez F, Casella F, Panegrossi G, Favetti F, Barresi C (2008) Perspectives on metaphyseal conservative stems. J Orthop Traumatol 9(1):49–54. doi:10.1007/s10195-008-0105-4 CrossRefPubMedPubMedCentral

10.

Freitag T, Kappe T, Fuchs M, Jung S, Reichel H, Bieger R (2014) Migration pattern of a femoral short-stem prosthesis: a 2-year EBRA-FCA-study. Arch Orthop Trauma Surg 134(7):1003–1008. doi:10.1007/s00402-014-1984-x CrossRefPubMed

11.

Rohrl SM, Li MG, Pedersen E, Ullmark G, Nivbrant B (2006) Migration pattern of a short femoral neck preserving stem. Clin Orthop Relat Res 448:73–78. doi:10.1097/01.blo.0000224000.87517.4c CrossRefPubMed

12.

Schmidutz F, Graf T, Mazoochian F, Fottner A, Bauer-Melnyk A, Jansson V (2012) Migration analysis of a metaphyseal anchored short-stem hip prosthesis. Acta Orthop 83(4):360–365. doi:10.3109/17453674.2012.712891 CrossRefPubMedPubMedCentral

13.

Khanuja HS, Banerjee S, Jain D, Pivec R, Mont MA (2014) Short bone-conserving stems in cementless hip arthroplasty. J Bone Joint Surg Am 96(20):1742–1752. doi:10.2106/JBJS.M.00780 CrossRefPubMed

14.

Watson-Jones R (1936) Fractures of the neck of the femur. Br J Surg 23:787–808CrossRef

15.

Biedermann R, Krismer M, Stockl B, Mayrhofer P, Ornstein E, Franzen H (1999) Accuracy of EBRA-FCA in the measurement of migration of femoral components of total hip replacement. Einzel-Bild-Rontgen-Analyse-femoral component analysis. J Bone Joint Surg (Br) 81(2):266–272CrossRef

16.

Engh CA, Bobyn JD, Glassman AH (1987) Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br) 69(1):45–55

17.

Ritter MA, Vaughn BK, Frederick LD (1995) Single-stage, bilateral, cementless total hip arthroplasty. J Arthroplasty 10(2):151–156CrossRefPubMed

18.

Radl R, Aigner C, Hungerford M, Pascher A, Windhager R (2000) Proximal femoral bone loss and increased rate of fracture with a proximally hydroxyapatite-coated femoral component. J Bone Joint Surg (Br) 82(8):1151–1155CrossRef

19.

Markmiller M, Weiss T, Kreuz P, Ruter A, Konrad G (2011) Partial weightbearing is not necessary after cementless total hip arthroplasty: a two-year prospective randomized study on 100 patients. Int Orthop 35(8):1139–1143. doi:10.1007/s00264-010-1089-2 CrossRefPubMed

20.

Thien TM, Ahnfelt L, Eriksson M, Stromberg C, Karrholm J (2007) Immediate weight bearing after uncemented total hip arthroplasty with an anteverted stem: a prospective randomized comparison using radiostereometry. Acta Orthop 78(6):730–738. doi:10.1080/17453670710014491 CrossRefPubMed

21.

Bieger R, Ignatius A, Reichel H, Durselen L (2013) Biomechanics of a short stem: in vitro primary stability and stress shielding of a conservative cementless hip stem. J Orthop Res 31(8):1180–1186CrossRefPubMed

22.

Brinkmann V, Radetzki F, Delank KS, Wohlrab D, Zeh A (2015) A prospective randomized radiographic and dual-energy X-ray absorptiometric study of migration and bone remodeling after implantation of two modern short-stemmed femoral prostheses. J Orthop Traumatol 16(3):237–243. doi:10.1007/s10195-015-0335-1 CrossRefPubMedPubMedCentral

23.

Budde S, Seehaus F, Schwarze M, Hurschler C, Floerkemeier T, Windhagen H et al (2015) Analysis of migration of the Nanos(R) short-stem hip implant within two years after surgery. Int Orthop. doi:10.1007/s00264-015-2999-9 PubMed

24.

McCalden RW, Korczak A, Somerville L, Yuan X, Naudie DD (2015) A randomised trial comparing a short and a standard-length metaphyseal engaging cementless femoral stem using radiostereometric analysis. Bone Joint J 97-B(5):595–602. doi:10.1302/0301-620X.97B5.34994 CrossRefPubMed

25.

Ruben RB, Fernandes PR, Folgado J (2012) On the optimal shape of hip implants. J Biomech 45(2):239–246. doi:10.1016/j.jbiomech.2011.10.038 CrossRefPubMed

Title: One-stage bilateral versus unilateral short-stem total hip arthroplasty: comparison of migration patterns using “Ein-Bild-Roentgen-Analysis Femoral-Component-Analysis”
Authors: Karl Philipp Kutzner
Tobias Freitag
Mark-Predg Kovacevis
Dominik Pfeil
Heiko Reichel
Ralf Bieger
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 1/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3184-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

One-stage bilateral versus unilateral short-stem total hip arthroplasty: comparison of migration patterns using “Ein-Bild-Roentgen-Analysis Femoral-Component-Analysis”

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2017

Minimally invasive transaxial lumbosacral interbody fusion: a ten year single-centre experience

Paul of Aegina (ca 625-690 AD), and his orthopaedic surgical reconstruction of the preternatural fingers

Total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis: a meta-analysis of comparative studies

Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

The Müller self-locking cemented total hip prosthesis with polyethylene liner: After twenty years, what did they become?

Discrepancy of alignment in different weight bearing conditions before and after high tibial osteotomy