Introduction: The purpose of this study was to compare the rates of revision, periprosthetic joint infection (PJI), and periprosthetic fracture (PPF) between patients with osteonecrosis of the femoral head (ONFH) undergoing noncemented total hip arthroplasty (THA) and cemented THA using a national claim data in South Korea.
Methods: We identified patients who received THA for ONFH from January 2007 to December 2018 using ICD diagnosis codes and procedural codes. Patients were categorized into two groups according to the fixation method: with or without cement. The survivorship of THA was calculated using the following end points: revision of both the cup and stem, revision of the single component, any type of revision, PJI, and PPF.
Results: A total of 40,606 patients: 3,738 patients (9.2%) with cement and 36,868 patients (90.7%) without cement, received THA for ONFH. The mean age of the noncemented fixation group (56.2 ± 13.2 years) was significantly lower than that of the cemented fixation group (57.0 ± 15.7 years, P = 0.003). The risk of revision and PJI was notably higher in cemented THA (hazard ratio: 1.44 [1.21 to 1.72] and 1.66 [1.36 to 2.04], respectively). Noncemented THA had a higher 12-year survivorship compared with cemented THA with any revision and PJI as the end point.
Discussion: Noncemented fixation had better survivorship than cemented fixation in patients with ONFH.
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http://dx.doi.org/10.5435/JAAOSGlobal-D-23-00029 | DOI Listing |
Acta Orthop
January 2025
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
Background And Purpose: Computed tomography radiostereometric analysis (CT-RSA) assesses implant micromovements using low-dose CT scans. We aimed to investigate whether CT-RSA is comparable to marker-based radiostereometric analysis (RSA) measuring early femoral head migration in cemented stems. We hypothesized that CT-RSA is comparable to marker-based RSA in evaluating femoral head subsidence.
View Article and Find Full Text PDFIntroduction: For total hip arthroplasty (THA) to be successful, surgeons need to make several decisions ranging from implant choice to impaction force. It is unclear, however, whether and how bone quality affects surgeon's decision-making and how surgeons evaluate bone quality.
Objectives: This inductive/deductive qualitative hybrid study aims to explore the impact of bone quality on the decision-making of surgeons performing elective primary THA.
Expert Rev Med Devices
January 2025
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Introduction: There is a worldwide trend toward 'revisiting' cemented total hip arthroplasty (THA). In Japan, however, cemented THAs accounts for 11%, and the percentage of cemented hemiarthroplasty is estimated to be less than 10%. This review was designed to reconsider the option of cemented THA and to encourage policy changes in Japan to support the best possible care for patients.
View Article and Find Full Text PDFBone Joint J
January 2025
Grampian Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK.
Aims: The Exeter femoral stem has a cemented, polished taper-slip design, and an excellent track record. The current range includes short-length options for various offsets, but less is known about the performance of these stems. The aim of this study was to compare the survival of short-length stems with standard-length Exeter stems.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Orthopedics and Trauma Surgery, Ospedale Civile Maggiore Di Borgo Trento, University of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, VR, Italy.
Purpose: The main objective of this prospective study was to assess clinical, radiographic and safety mid-term outcomes after THA with a short cemented stem in an elderly patient cohort. Moreover, the study aimed at investigating the mid-term survivorship of the implant and the incidence of complications.
Methods: 96 consecutive patients (100 cases) underwent THA with a short cemented stem.
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