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Published in: MUSCULOSKELETAL SURGERY 3/2019

01-12-2019 | Original Article

Is there any difference between tapered titanium stems with similar geometry and hydroxyapatite coating?

Authors: G. Cinotti, G. Mazzotta, F. Romana Ripani, G. La Torre, G. Giannicola

Published in: MUSCULOSKELETAL SURGERY | Issue 3/2019

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Abstract

Purpose

Several tapered stems with similar geometry and extensive hydroxyapatite coating have recently been introduced. It is not clear, however, whether they share the same design or whether they exhibit any difference that might affect their clinical performances. In this study, we analysed five tapered stems fully coated with hydroxyapatite to establish whether they exhibit similar geometric features and may therefore be used indifferently when a cementless stem is indicated.

Methods

The length of the stem, the coronal and sagittal diameters, the length of the stem shoulder and the metadiaphyseal angle were measured. The ratio between the proximal and distal coronal diameters of the stem and that between the proximal and distal cross-sectional areas were calculated as a flare index and tapered index, respectively.

Results

The proximal coronal diameter ranged between 24.9 and 28 mm in the smaller size and between 34 and 38.4 mm in the largest sizes. The proximal sagittal diameter ranged between 10.2 and 11.8 in the smallest size and between 14.4 and 17.2 in the largest. A significant difference was found between stems of different brands in the flare index, tapered index, length of stem shoulder and metadiaphyseal angle.

Conclusions

Lookalike tapered stems with extensive HA coating actually exhibit significant differences in several geometric features potentially affecting their clinical performances. As a result, these stems should not be used indifferently, but rather they should be selected on the basis of the femoral morphology of the operated patient.
Literature
1.
go back to reference Froimson MI, Garino J, Machenaud A, Vidalain JP (2007) Minimum 10-year results of a tapered, titanium, hydroxyapatite-coated hip stem an independent review. J Arthroplasty 22:1–7CrossRef Froimson MI, Garino J, Machenaud A, Vidalain JP (2007) Minimum 10-year results of a tapered, titanium, hydroxyapatite-coated hip stem an independent review. J Arthroplasty 22:1–7CrossRef
2.
go back to reference Hallan G, Lie SA, Furnes O, Engesaeter LB, Vollset SE, Havelin LI (2007) Medium- and long-term performance of 11.516 uncemented primary femoral stems from the Norwegian arthroplasty register. J Bone Joint Surg Br 89:1574–1580CrossRef Hallan G, Lie SA, Furnes O, Engesaeter LB, Vollset SE, Havelin LI (2007) Medium- and long-term performance of 11.516 uncemented primary femoral stems from the Norwegian arthroplasty register. J Bone Joint Surg Br 89:1574–1580CrossRef
3.
go back to reference Vidalain J-P (2011) Twenty-year results of cementless Corail stem. Int Orthop 35:189–194CrossRef Vidalain J-P (2011) Twenty-year results of cementless Corail stem. Int Orthop 35:189–194CrossRef
4.
go back to reference Bloebaum RD, Zou L, Bachus KN, Shea KG, Hofmann AA, Dunn HK (1997) Analysis of particles in acetabular components from patients with osteolysis. Clin Orthop Relat Res 338:109–118CrossRef Bloebaum RD, Zou L, Bachus KN, Shea KG, Hofmann AA, Dunn HK (1997) Analysis of particles in acetabular components from patients with osteolysis. Clin Orthop Relat Res 338:109–118CrossRef
5.
go back to reference Collier JP, Surprenant VA, Mayor MB, Wrona M, Jensen RE, Surprenant HP (1993) Loss of hydroxyapatite coating on retrieved, total hip components. J Arthroplasty 8(4):389–393CrossRef Collier JP, Surprenant VA, Mayor MB, Wrona M, Jensen RE, Surprenant HP (1993) Loss of hydroxyapatite coating on retrieved, total hip components. J Arthroplasty 8(4):389–393CrossRef
6.
go back to reference Rbkkum M, Registad A, Johansson CB (2002) HA particles can be released from well-fixed HA-coated stems. Histopathology of biopsies from 20 hips 2–8 years after implantation. Acta Orthop Scand 73:298CrossRef Rbkkum M, Registad A, Johansson CB (2002) HA particles can be released from well-fixed HA-coated stems. Histopathology of biopsies from 20 hips 2–8 years after implantation. Acta Orthop Scand 73:298CrossRef
7.
go back to reference Sudhahar TA, Morapudi S, Branes K (2009) Evaluation of subsidence between collarless and collared corail femoral cementless total hip replacement. J Orthop 6(2):e3 Sudhahar TA, Morapudi S, Branes K (2009) Evaluation of subsidence between collarless and collared corail femoral cementless total hip replacement. J Orthop 6(2):e3
8.
go back to reference Callary SA, Campbell DG, Mercer GE, Nilsson KG, Field JR (2012) The 6-year migration characteristics of a hydroxyapatite-coated femoral stem: a radiostereometric analysis study. J Arthroplasty 27:1344–1348CrossRef Callary SA, Campbell DG, Mercer GE, Nilsson KG, Field JR (2012) The 6-year migration characteristics of a hydroxyapatite-coated femoral stem: a radiostereometric analysis study. J Arthroplasty 27:1344–1348CrossRef
9.
go back to reference Campbell D, Mercer G, Nilsson KG, Wells V, Field JR, Callary SA (2011) Early migration characteristics of a hydroxyapatite-coated femoral stem: an RSA study. Int Orthop 35(4):483–488CrossRef Campbell D, Mercer G, Nilsson KG, Wells V, Field JR, Callary SA (2011) Early migration characteristics of a hydroxyapatite-coated femoral stem: an RSA study. Int Orthop 35(4):483–488CrossRef
10.
go back to reference Pentlow AK, Heal JS (2012) Subsidence of collarless uncemented femoral stems in total hips replacements performed for trauma. Injury Int J Care Injured 43:882–885CrossRef Pentlow AK, Heal JS (2012) Subsidence of collarless uncemented femoral stems in total hips replacements performed for trauma. Injury Int J Care Injured 43:882–885CrossRef
11.
go back to reference Selvaratnam V, Shetty V, Sahni V (2015) Subsidence in collarless Corail hip replacement. The Open Orthop J 9:194–197CrossRef Selvaratnam V, Shetty V, Sahni V (2015) Subsidence in collarless Corail hip replacement. The Open Orthop J 9:194–197CrossRef
13.
go back to reference Hirata Y, Inaba Y, Kobayashi N, Ike H, Fujimaki H, Saito T (2013) Comparison of mechanical stress and change in bone mineral density between two types of femoral implant using finite element analysis. J Arthroplasty 28:1731–1735CrossRef Hirata Y, Inaba Y, Kobayashi N, Ike H, Fujimaki H, Saito T (2013) Comparison of mechanical stress and change in bone mineral density between two types of femoral implant using finite element analysis. J Arthroplasty 28:1731–1735CrossRef
14.
go back to reference Huiskes R (1999) The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop Relat Res 261:27–38 Huiskes R (1999) The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop Relat Res 261:27–38
15.
go back to reference Sano K, Ito K, Yamamoto K (2008) Changes of bone mineral density after cementless total hip arthroplasty with two different stems. Int Orthop 32(2):167CrossRef Sano K, Ito K, Yamamoto K (2008) Changes of bone mineral density after cementless total hip arthroplasty with two different stems. Int Orthop 32(2):167CrossRef
16.
go back to reference van der Wal BC, de Kramer BJ, Grimm B, Vencken W, Heyligers IC, Tonino AJ (2008) Femoral fit in ABG-II hip stems, influence on clinical outcome and bone remodeling: a radiographic study. Arch Orthop Trauma Surg 128(10):1065CrossRef van der Wal BC, de Kramer BJ, Grimm B, Vencken W, Heyligers IC, Tonino AJ (2008) Femoral fit in ABG-II hip stems, influence on clinical outcome and bone remodeling: a radiographic study. Arch Orthop Trauma Surg 128(10):1065CrossRef
17.
go back to reference Capello WN, D’Antonio JA, Geesink RG, Feinberg JR, Naughton M (2009) Late remodeling around a proximally HA-coated tapered titanium femoral component. Clin Orthop Rel Res 467:155–165CrossRef Capello WN, D’Antonio JA, Geesink RG, Feinberg JR, Naughton M (2009) Late remodeling around a proximally HA-coated tapered titanium femoral component. Clin Orthop Rel Res 467:155–165CrossRef
18.
go back to reference Cooper HJ, Jacob AP, Rodriguez JA (2011) Distal fixation of proximally coated tapered stems may predispose to a failure of osteointegration. J Arthroplasty 26:78–83CrossRef Cooper HJ, Jacob AP, Rodriguez JA (2011) Distal fixation of proximally coated tapered stems may predispose to a failure of osteointegration. J Arthroplasty 26:78–83CrossRef
19.
go back to reference Mueller LA, Nowak TE, Haeberle L, Mueller LP, Kress A, Voelk M et al (2010) Progressive femoral cortical and cancellous bone density loss after uncemented tapered-design stem fixation. A 6-year follow-up. Acta Orthop 81:171–177CrossRef Mueller LA, Nowak TE, Haeberle L, Mueller LP, Kress A, Voelk M et al (2010) Progressive femoral cortical and cancellous bone density loss after uncemented tapered-design stem fixation. A 6-year follow-up. Acta Orthop 81:171–177CrossRef
20.
go back to reference Panisello JJ, Herrero L, Canales V, Herrera H, Martínez A, Mateo J (2009) Long-term remodeling in proximal femur around a hydroxyapatite-coated anatomic stem ten years densitometric follow-up. J Arthroplasty 24:56–64CrossRef Panisello JJ, Herrero L, Canales V, Herrera H, Martínez A, Mateo J (2009) Long-term remodeling in proximal femur around a hydroxyapatite-coated anatomic stem ten years densitometric follow-up. J Arthroplasty 24:56–64CrossRef
22.
go back to reference Kim Y-H (2008) The results of a proximally-coated Cementless femoral component in total hip replacement. A five-to 12-year follow-up. J Bone Joint Surg Br 90:299–305CrossRef Kim Y-H (2008) The results of a proximally-coated Cementless femoral component in total hip replacement. A five-to 12-year follow-up. J Bone Joint Surg Br 90:299–305CrossRef
23.
go back to reference Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH (1993) Structural and cellular assessment of bone quality of proximal femur. Bone 14:231–242CrossRef Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH (1993) Structural and cellular assessment of bone quality of proximal femur. Bone 14:231–242CrossRef
Metadata
Title
Is there any difference between tapered titanium stems with similar geometry and hydroxyapatite coating?
Authors
G. Cinotti
G. Mazzotta
F. Romana Ripani
G. La Torre
G. Giannicola
Publication date
01-12-2019
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue 3/2019
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-018-00586-8

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