Clin Orthop Surg.  2013 Jun;5(2):110-117. 10.4055/cios.2013.5.2.110.

Fifteen-year Results of Precoated Femoral Stem in Primary Hybrid Total Hip Arthroplasty

• Suh DH
• Yun HH
• Chun SK
• Shon WY

• KMID: 1705531
• DOI: http://doi.org/10.4055/cios.2013.5.2.110

Abstract

BACKGROUND
There has been controversy whether methylmethacrylate precoating of the cemented femoral stem is a solution for aseptic loosening or rather contributes to increased failure rates in cemented total hip arthroplasties.
METHODS
On a retrospective basis, we analyzed 76 primary hybrid total hip arthroplasties from 63 patients with precoated, cemented femoral stems between October 1990 and December 1995. The mean age of the patients was 46.8 years (range, 22 to 77 years) with a minimum follow-up of 14 years (mean, 15.5 years; range, 14 to 19.5 years). Third generation cementing techniques were employed in all cases.
RESULTS
Twenty-four out of 76 cases (31.6%) showed aseptic loosening of the femoral stems, of which 23 stems were revised at an average revision time of 8 years (range, 3 to 14.8 years). The main mode of loosening was cement-stem interface failure in 22 hips (91.7%). Twenty-one out of 24 failed hips (87.5%) demonstrated C2 cementing grades (p < 0.001). Kaplan-Meier survivorship analysis using radiographic aseptic loosening of the femoral stem as the endpoint for failure showed survival rates of 76.5% at 10 years (95% confidence interval [CI], 71.4 to 81.6) and 63.2% at 19 years (95% CI, 57.3 to 69.1).
CONCLUSIONS
An early failure of the precoated femoral stem in this study was mainly due to an insufficient cementing technique. Achievement of good cement mantle may improve the survival rates.

Keyword

Methylmethacrylate precoating; Femoral stem; Total hip arthroplasty

MeSH Terms

Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip/*instrumentation
*Coated Materials, Biocompatible
Equipment Failure Analysis
Female
Femur Head Necrosis/diagnosis/surgery
*Hip Prosthesis
Humans
Kaplan-Meier Estimate
Male
Methylmethacrylate
Middle Aged
Prosthesis Failure
Retrospective Studies
Treatment Outcome
Young Adult
Coated Materials, Biocompatible
Methylmethacrylate