Fixation and bone remodeling around a low stiffness stem in revision surgery

Clinical Orthopaedics and Related Research
Johan Kärrholm, Reza Razaznejad

Abstract

Femoral stems with reduced stiffness have the potential of decreasing stress shielding and could be an alternative in revision surgery when restoration of bone stock is required. We retrospectively reviewed 38 patients (40 stems) with a central core of cobalt-chromium surrounded by a polymer and an outer titanium mesh layer containing a proximal coating of hydroxyapatite/tricalcium phosphate; 30 of the 38 patients (32 hips) had a minimum 2-year followup. We impacted morselized allograft around the stem in 28 of 32 revisions. Repeated radiostereometric examinations showed medial, distal, and posterior migration (median, 0.21 mm, 0.17 mm, and 0.96 mm, respectively) of the femoral head center for up to 6 months followed by stabilization. Measurements of bone mineral density in the seven Gruen zones at 6 months revealed either a decrease (down to a median of 3%), no change, or a slight increase (up to 5%) followed by a further increase up to 2 years in three of the regions (2, 3, and 5). Conventional radiography at 2 years demonstrated graft remodeling and incomplete radiolucent lines in 19 hips, mainly in Regions 1 and 7. Two hips were reoperated on as a result of dislocation, but none of the stems had been revised. Level IV, ther...Continue Reading

References

Jan 1, 1991·The Journal of Bone and Joint Surgery. British Volume·G L MaistrelliI Harrington
Mar 1, 1990·The Journal of Arthroplasty·M A RitterP M Faris
Jul 1, 1984·The Journal of Bone and Joint Surgery. American Volume·H S TullosJ Davidson
Jan 1, 1994·Archives of Orthopaedic and Trauma Surgery·G PetrouA Kouzoupis
Jul 1, 1993·The Journal of Bone and Joint Surgery. British Volume·S A JacobssonI Ivarsson
Jan 1, 1993·The Journal of Bone and Joint Surgery. British Volume·G A GieA J Timperley
Jan 1, 1995·International Orthopaedics·T J NiinimäkiP K Jalovaara
Dec 5, 1998·Journal of Biomechanics·D R SumnerJ O Galante
Mar 4, 2000·The Journal of Bone and Joint Surgery. British Volume·J PekkarinenT Paavilainen
Jan 5, 2002·Clinical Orthopaedics and Related Research·A H GlassmanP Herberts
Aug 15, 2002·The Journal of Bone and Joint Surgery. American Volume·Harry K W Kim, Phi-Huynh Su
Dec 9, 2003·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·A I A RahmyI Fogelman
Sep 3, 2004·The Journal of Arthroplasty·Young-Hoo Kim
Jul 2, 2005·Journal of Biomechanics·Niclas BörlinCharles R Bragdon
Oct 1, 2005·Acta Orthopaedica·Edward R ValstarJohan Kärrholm
Mar 1, 2006·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·H S HediaN Fouda
Jun 8, 2006·The Journal of Bone and Joint Surgery. American Volume·Sam AkhavanVictor M Goldberg
Aug 25, 2006·Acta Orthopaedica·Jon H M GoosenCees C P M Verheyen
Oct 13, 2006·The Journal of the American Academy of Orthopaedic Surgeons·Daniel A Oakes, Miguel E Cabanela

❮ Previous
Next ❯

Citations

Feb 8, 2011·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Gösta UllmarkJens Sörensen
Jun 7, 2012·Clinical Orthopaedics and Related Research·Per-Erik JohansonJohan Kärrholm

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.