Skip to main content
Top
Published in: International Orthopaedics 3/2016

01-03-2016 | Original Paper

Ten to fifteen-year clinical and radiographic follow-up with a third-generation cementless stem in a young patient population

Authors: Peteris Studers, Danils Belajevs, Vitolds Jurkevics, Peteris Likums

Published in: International Orthopaedics | Issue 3/2016

Login to get access

Abstract

Purpose

Outcome data beyond 11 years of follow-up is not available for the third-generation Zweymüller femoral stem in combination with a polyethylene bearing. We report ten to 15-year results with this total hip arthroplasty (THA) combination in a young population.

Methods

A retrospective, observational, non-randomised, single-centre, clinical observational study was conducted in which 311 primary THAs were performed in 276 patients between 1996 and 2000 using a third-generation Zweymüller stem. The mean age of the patients at operation was 47.4 years (range 18–77 years).

Results

Stem survival for any reason was 93.5 % after ten years and 89.6 % after 13 years, and the probability of aseptic stem loosening was 98.7 % at both ten and 13 years. The occurrence of femoral radiolucent lines was low, at just 17.2 %. Minor femoral osteolysis was identified in 30 % of patients and was attributed to polyethylene liner wear. Clinical and patient satisfaction outcomes were in line with previous investigations, and the rate of adverse events was low.

Conclusions

The third-generation Zweymüller stem shows good radiographic and clinical results and good longevity, including in the younger osteoarthritic patient. The use of low-wear bearings may further reduce the rate of osteolysis and wear-related revision in young and active patients.
Literature
1.
go back to reference Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P (2005) Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register. 4,661 primary replacements followed for 0–22 years. Acta Orthop 76(1):28–41CrossRefPubMed Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P (2005) Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register. 4,661 primary replacements followed for 0–22 years. Acta Orthop 76(1):28–41CrossRefPubMed
2.
go back to reference Malchau H, Herberts P, Eisler T, Garellick G, Soderman P (2002) The Swedish total hip replacement register. J Bone Joint Surg Am 84-A(Suppl 2):2–20PubMed Malchau H, Herberts P, Eisler T, Garellick G, Soderman P (2002) The Swedish total hip replacement register. J Bone Joint Surg Am 84-A(Suppl 2):2–20PubMed
3.
go back to reference Havelin LI, Engesaeter LB, Espehaug B, Furnes O, Lie SA, Vollset SE (2000) The Norwegian arthroplasty register: 11 years and 73,000 arthroplasties. Acta Orthop Scand 71(4):337–353CrossRefPubMed Havelin LI, Engesaeter LB, Espehaug B, Furnes O, Lie SA, Vollset SE (2000) The Norwegian arthroplasty register: 11 years and 73,000 arthroplasties. Acta Orthop Scand 71(4):337–353CrossRefPubMed
4.
go back to reference Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755PubMed Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755PubMed
5.
go back to reference Klassbo M, Larsson E, Mannevik E (2003) Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. Scand J Rheumatol 32(1):46–51CrossRefPubMed Klassbo M, Larsson E, Mannevik E (2003) Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. Scand J Rheumatol 32(1):46–51CrossRefPubMed
6.
go back to reference Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM (2003) Hip disability and osteoarthritis outcome score (HOOS)—validity and responsiveness in total hip replacement. BMC Musculoskelet Disord 4:10PubMedCentralCrossRefPubMed Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM (2003) Hip disability and osteoarthritis outcome score (HOOS)—validity and responsiveness in total hip replacement. BMC Musculoskelet Disord 4:10PubMedCentralCrossRefPubMed
7.
go back to reference Gruen T, McNeice G, Amstutz H (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27PubMed Gruen T, McNeice G, Amstutz H (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27PubMed
8.
go back to reference Zweymüller K (2007) Good results with an uncoated grit-blasted tapered straight stem at ten years. Interact Surg 2(3):197–2005CrossRef Zweymüller K (2007) Good results with an uncoated grit-blasted tapered straight stem at ten years. Interact Surg 2(3):197–2005CrossRef
9.
go back to reference Brooker A, Bowerman J, Robinson R, Riley LJ (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55(8):1629–1632PubMed Brooker A, Bowerman J, Robinson R, Riley LJ (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55(8):1629–1632PubMed
10.
go back to reference Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128PubMed Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128PubMed
11.
go back to reference Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef
12.
go back to reference Korovessis P, Repantis T, Zafiropoulos A (2011) High medium-term survivorship and durability of Zweymuller-Plus total hip arthroplasty. Arch Orthop Trauma Surg 131(5):603–611CrossRefPubMed Korovessis P, Repantis T, Zafiropoulos A (2011) High medium-term survivorship and durability of Zweymuller-Plus total hip arthroplasty. Arch Orthop Trauma Surg 131(5):603–611CrossRefPubMed
13.
go back to reference Milosev I, Kovac S, Trebse R, Levasic V, Pisot V (2012) Comparison of ten-year survivorship of hip prostheses with use of conventional polyethylene, metal-on-metal, or ceramic-on-ceramic bearings. J Bone Joint Surg Am 94(19):1756–1763CrossRefPubMed Milosev I, Kovac S, Trebse R, Levasic V, Pisot V (2012) Comparison of ten-year survivorship of hip prostheses with use of conventional polyethylene, metal-on-metal, or ceramic-on-ceramic bearings. J Bone Joint Surg Am 94(19):1756–1763CrossRefPubMed
14.
go back to reference Topolovec M, Milosev I (2014) A comparative study of four bearing couples of the same acetabular and femoral component: a mean follow-up of 11.5 years. J Arthroplasty 29(1):176–180CrossRefPubMed Topolovec M, Milosev I (2014) A comparative study of four bearing couples of the same acetabular and femoral component: a mean follow-up of 11.5 years. J Arthroplasty 29(1):176–180CrossRefPubMed
15.
go back to reference Wick M, Lester DK (2004) Radiological changes in second- and third-generation Zweymuller stems. J Bone Joint Surg (Br) 86(8):1108–1114CrossRef Wick M, Lester DK (2004) Radiological changes in second- and third-generation Zweymuller stems. J Bone Joint Surg (Br) 86(8):1108–1114CrossRef
16.
go back to reference Grubl A, Chiari C, Giurea A et al (2006) Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88(10):2210–2215CrossRefPubMed Grubl A, Chiari C, Giurea A et al (2006) Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88(10):2210–2215CrossRefPubMed
17.
go back to reference Pospischill M, Knahr K (2005) Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem. Follow-up for ten to 17 years. J Bone Joint Surg (Br) 87(9):1210–1215CrossRef Pospischill M, Knahr K (2005) Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem. Follow-up for ten to 17 years. J Bone Joint Surg (Br) 87(9):1210–1215CrossRef
18.
go back to reference Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P (2006) Uncemented total hip arthroplasty for primary osteoarthritis in young patients: a mid-to long-term follow-up study from the Finnish Arthroplasty Register. Acta Orthop 77(1):57–70CrossRefPubMed Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P (2006) Uncemented total hip arthroplasty for primary osteoarthritis in young patients: a mid-to long-term follow-up study from the Finnish Arthroplasty Register. Acta Orthop 77(1):57–70CrossRefPubMed
19.
go back to reference Kim YH, Kim JS, Park JW, Joo JH (2011) Comparison of total hip replacement with and without cement in patients younger than 50 years of age: the results at 18 years. J Bone Joint Surg (Br) 93(4):449–455CrossRef Kim YH, Kim JS, Park JW, Joo JH (2011) Comparison of total hip replacement with and without cement in patients younger than 50 years of age: the results at 18 years. J Bone Joint Surg (Br) 93(4):449–455CrossRef
20.
go back to reference Zweymuller KA, Steindl M, Schwarzinger U (2007) Good stability and minimal osteolysis with a biconical threaded cup at 10 years. Clin Orthop Relat Res 463:128–137PubMed Zweymuller KA, Steindl M, Schwarzinger U (2007) Good stability and minimal osteolysis with a biconical threaded cup at 10 years. Clin Orthop Relat Res 463:128–137PubMed
21.
go back to reference Tozun IR, Ozden VE, Dikmen G, Beksac B (2014) Mid-term result of ceramic bearings in total hip arthroplasty. Int Orthop 38(10):2027–2031CrossRefPubMed Tozun IR, Ozden VE, Dikmen G, Beksac B (2014) Mid-term result of ceramic bearings in total hip arthroplasty. Int Orthop 38(10):2027–2031CrossRefPubMed
22.
go back to reference Salemyr M, Muren O, Ahl T, Boden H, Chammout G, Stark A, Skoldenberg O (2015) Vitamin-E diffused highly cross-linked polyethylene liner compared to standard liners in total hip arthroplasty. A randomized, controlled trial. Int Orthop Salemyr M, Muren O, Ahl T, Boden H, Chammout G, Stark A, Skoldenberg O (2015) Vitamin-E diffused highly cross-linked polyethylene liner compared to standard liners in total hip arthroplasty. A randomized, controlled trial. Int Orthop
23.
go back to reference Zweymuller K, Schwarzinger U, Steindl M (2006) Radiolucent lines and osteolysis along tapered straight cementless titanium hip stems: a comparison of 6-year and 10-year follow-up results in 95 patients. Acta Orthop 77(6):871–876CrossRefPubMed Zweymuller K, Schwarzinger U, Steindl M (2006) Radiolucent lines and osteolysis along tapered straight cementless titanium hip stems: a comparison of 6-year and 10-year follow-up results in 95 patients. Acta Orthop 77(6):871–876CrossRefPubMed
24.
go back to reference Archibeck M, Berger R, Jacobs J (2001) Second-generation cementless total hip arthroplasty. Eight to eleven-year results. J Bone Joint Surg 83-A:1666–1673PubMed Archibeck M, Berger R, Jacobs J (2001) Second-generation cementless total hip arthroplasty. Eight to eleven-year results. J Bone Joint Surg 83-A:1666–1673PubMed
25.
go back to reference Pieringer H, Auersperg V, Griessler W, Bohler N (2003) Long-term results with the cementless Alloclassic brand hip arthroplasty system. J Arthroplasty 18(3):321–328CrossRefPubMed Pieringer H, Auersperg V, Griessler W, Bohler N (2003) Long-term results with the cementless Alloclassic brand hip arthroplasty system. J Arthroplasty 18(3):321–328CrossRefPubMed
26.
go back to reference Koster G, Leib S, Willert H (1998) Noncemented hip replacement using a conical screw-in cup and a straight press-fit stem. A six to eight-year clinical and radiological follow-up study. Hip Int 8:208–218 Koster G, Leib S, Willert H (1998) Noncemented hip replacement using a conical screw-in cup and a straight press-fit stem. A six to eight-year clinical and radiological follow-up study. Hip Int 8:208–218
27.
go back to reference Lintner F, Zweymuller K, Brand G (1986) Tissue reactions to titanium endoprostheses. Autopsy studies in four cases. J Arthroplasty 1(3):183–195CrossRefPubMed Lintner F, Zweymuller K, Brand G (1986) Tissue reactions to titanium endoprostheses. Autopsy studies in four cases. J Arthroplasty 1(3):183–195CrossRefPubMed
28.
go back to reference Zweymuller K, Samek V (1990) In: Zweymuller K (ed) Radiologische Grundphanomene des Titanium-Geradschaftes. Verlag Hans Huber, Bern, p 23 Zweymuller K, Samek V (1990) In: Zweymuller K (ed) Radiologische Grundphanomene des Titanium-Geradschaftes. Verlag Hans Huber, Bern, p 23
29.
go back to reference Biemond JE, Venkatesan S, van Hellemondt GG (2015) Survivorship of the cementless Spotorno femoral component in patients under 50 years of age at a mean follow-up of 18.4 years. Bone Joint J 97-B(2):160–163CrossRefPubMed Biemond JE, Venkatesan S, van Hellemondt GG (2015) Survivorship of the cementless Spotorno femoral component in patients under 50 years of age at a mean follow-up of 18.4 years. Bone Joint J 97-B(2):160–163CrossRefPubMed
30.
go back to reference McLaughlin JR, Lee KR (2014) Uncemented total hip arthroplasty using a tapered femoral component in obese patients: an 18–27 year follow-up study. J Arthroplasty 29(7):1365–1368CrossRefPubMed McLaughlin JR, Lee KR (2014) Uncemented total hip arthroplasty using a tapered femoral component in obese patients: an 18–27 year follow-up study. J Arthroplasty 29(7):1365–1368CrossRefPubMed
31.
go back to reference Innmann MM, Gotterbarm T, Kretzer JP et al (2014) Minimum ten-year results of a 28-mm metal-on-metal bearing in cementless total hip arthroplasty in patients fifty years of age and younger. Int Orthop 38(5):929–934PubMedCentralCrossRefPubMed Innmann MM, Gotterbarm T, Kretzer JP et al (2014) Minimum ten-year results of a 28-mm metal-on-metal bearing in cementless total hip arthroplasty in patients fifty years of age and younger. Int Orthop 38(5):929–934PubMedCentralCrossRefPubMed
32.
go back to reference Pieringer H, Labek G, Auersperg V, Bohler N (2003) Cementless total hip arthroplasty in patients older than 80 years of age. J Bone Joint Surg (Br) 85(5):641–645 Pieringer H, Labek G, Auersperg V, Bohler N (2003) Cementless total hip arthroplasty in patients older than 80 years of age. J Bone Joint Surg (Br) 85(5):641–645
33.
go back to reference Chen C, Xenos J, McAuley J, Young A, Engh CS (2006) Second-generation porous-coated cementless total hip arthroplasties have high survival. Clin Orthop Relat Res 451:121–127CrossRefPubMed Chen C, Xenos J, McAuley J, Young A, Engh CS (2006) Second-generation porous-coated cementless total hip arthroplasties have high survival. Clin Orthop Relat Res 451:121–127CrossRefPubMed
34.
go back to reference Garcia-Cimbrelo E, Cruz-Pardos A, Madero R, Ortega-Andreu M (2003) Total hip arthroplasty with use of the cementless Zweymuller Alloclassic system. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 85-A(2):296–303PubMed Garcia-Cimbrelo E, Cruz-Pardos A, Madero R, Ortega-Andreu M (2003) Total hip arthroplasty with use of the cementless Zweymuller Alloclassic system. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 85-A(2):296–303PubMed
35.
go back to reference Grubl A, Chiari C, Gruber M, Kaider A, Gottsauner-Wolf F (2002) Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup: a minimum ten-year follow-up. J Bone Joint Surg Am 84-A(3):425–431PubMed Grubl A, Chiari C, Gruber M, Kaider A, Gottsauner-Wolf F (2002) Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup: a minimum ten-year follow-up. J Bone Joint Surg Am 84-A(3):425–431PubMed
36.
go back to reference Sinha R, Dungy D, Yeon H (2004) Primary total hip arthroplasty with a proximally porous-coated femoral stem. J Bone Joint Surg 86-A:1254–1261PubMed Sinha R, Dungy D, Yeon H (2004) Primary total hip arthroplasty with a proximally porous-coated femoral stem. J Bone Joint Surg 86-A:1254–1261PubMed
37.
go back to reference Surdam J, Archibeck M, Schultz S, Junick D, White R (2007) A second-generation cementless total hip arthroplasty mean 9-year results. J Arthroplasty 22:204–209CrossRefPubMed Surdam J, Archibeck M, Schultz S, Junick D, White R (2007) A second-generation cementless total hip arthroplasty mean 9-year results. J Arthroplasty 22:204–209CrossRefPubMed
Metadata
Title
Ten to fifteen-year clinical and radiographic follow-up with a third-generation cementless stem in a young patient population
Authors
Peteris Studers
Danils Belajevs
Vitolds Jurkevics
Peteris Likums
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 3/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2846-z

Other articles of this Issue 3/2016

International Orthopaedics 3/2016 Go to the issue