Z Orthop Unfall 2007; 145: S40-S43
DOI: 10.1055/s-2007-965659
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

The Uncemented Primary Bicontact Stem in Revision Total Hip Arthroplasty in Young Patients

F. Thorey1 , M. Lerch1 , H. Kiel1 , G. von Lewinski1 , C. Stukenborg-Colsman1 , H. Windhagen1
  • 1Department of Orthopaedic Surgery, Hannover Medical School, Germany
Further Information

Publication History

Publication Date:
16 October 2007 (online)

Abstract

Aim: The purpose of this study was to evaluate the uncemented primary Bicontact stem (B.Braun-Aesculap, Tuttlingen, Germany) as a possible adequate alternative to other revision systems in revision total hip arthroplasty. Methods: Twenty patients aged up to 58 years (34 - 58 years, mean age 5.7 ± 5.8 years) with minor bone defects underwent a revision total hip arthroplasty with the uncemented primary Bicontact stem. The patients were assessed clinically and radiologically at follow-up (follow-up: 8.0 ± 3. years). Results: The postoperative Harris Hip Score, Motion and Pain Score improved significantly. There was only one further revision in these patients because of infection and only one case with mild stress shielding. Conclusion: The uncemented primary Bicontact stem seems to be a good alternative to other revision systems in total hip revision arthroplasty in young patients.

References

  • 1 Hungerford D S, Jones L C. The rationale for cementless total hip replacement.  Orthop Clin North Am. 1993;  24 617-626
  • 2 Krishnamurthy A B, MacDonald S J, Paprosky W G. 5- to 13-year follow-up study on cementless femoral components in revision surgery.  J Arthroplasty. 1997;  12 839-847
  • 3 Lawrence J M, Engh C A, Macalino G E, Lauro G R. Outcome of revision hip arthroplasty done without cement.  J Bone Joint Surg [Am]. 1994;  76 965-973
  • 4 Moreland J R, Bernstein M L. Femoral revision hip arthroplasty with uncemented, porous-coated stems.  Clin Orthop Relat Res. 1995;  319 141-150
  • 5 Moreland J R, Moreno M A. Cementless femoral revision arthroplasty of the hip: minimum 5 years followup.  Clin Orthop Relat Res. 2001;  393 194-201
  • 6 Paprosky W G, Greidanus N V, Antoniou J. Minimum 10-year-results of extensively porous-coated stems in revision hip arthroplasty.  Clin Orthop Relat Res. 1999;  369 230-242
  • 7 Herberts P, Malchau H. Long-term registration has improved the quality of hip replacement. A review of the Swedish THR register comparing 160 000 cases.  Acta Orthop Scand. 2000;  71 111-121
  • 8 Furnes O, Lei S A, Espelhaug B, Vollset S E, Engesaeter L, Havelin L I. Hip disease and the prognosis of total hip replacements. A review of 53 698 primary total hip replacements reported to the Norwegian arthroplasty register 1987 - 99.  J Bone Joint Surg [Br]. 2001;  83 579-586
  • 9 Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P. Total hip arthroplasty for primary osteoarthritis in young patients in the Finnish arthroplasty register. 4661 primary replacements followed for 0.22 years.  Acta Orthop Scand. 2006;  76 28-41
  • 10 Paprosky W G, Bradford M S, Younger T I. Classification of bone defects in failed prostheses.  Chir Organi Mov. 1994;  79 285-291
  • 11 Paprosky W G, Burnett R S. Assessment and classification of bone stock deficiency in revision total hip arthroplasty.  Am J Orthop. 2002;  31 459-464
  • 12 Kavanagh B F, Ilstrup D M, Fitzgerald Jr R H. Revision total hip arthroplasty.  J Bone Joint Surg [Am]. 1985;  67 517-526
  • 13 Katz R P, Callaghan J J, Sullivan P M, Johnston R C. Results of cemented femoral revision total hip arthroplasty using improved cementing techniques.  Clin Orthop Relat Res. 1995;  319 178-183
  • 14 Mulroy W F, Harris W H. Revision total hip arthroplasty with use of so-called second-generation cementing techniques for aseptic loosening of the femoral component. A fifteen-year-average follow-up study.  J Bone Joint Surg [Am]. 1996;  78 325-330
  • 15 Berry D J, Harmsen W S, Ilstrup D, Lewallen D G, Cabanela M E. Survivorship of uncemented proximally porous-coated femoral components.  Clin Orthop Relat Res. 1995;  319 168-177
  • 16 Harris W H, Krushell R J, Galante J O. Results of cementless revisions of total hip arthroplasties using the Harris-Galante prosthesis.  Clin Orthop Relat Res. 1988;  235 120-126
  • 17 Malkani A L, Lewallen D G, Cabanela M E, Wallrichs S L. Femoral component revision using an uncemented, proximally coated, long-stem prosthesis.  J Arthroplasty. 1996;  11 411-418
  • 18 Mulliken B D, Rorabeck C H, Bourne R B. Uncemented revision total hip arthroplasty: a 4-to-6-year review.  Clin Orthop Relat Res. 1996;  325 156-162
  • 19 Pellicci P M, Wilson Jr P D, Sledge C B, Salvati E A, Ranawat C S, Poss R, Callaghan J J. Long-term results of revision total hip replacement. A follow-up report.  J Bone Joint Surg [Am]. 1985;  67 513-516
  • 20 Peters C L, Rivero D P, Kull L R, Jacobs J J, Rosenberg A G, Galante J O. Revision total hip arthroplasty without cement: subsidence of proximally porous-coated femoral components.  J Bone Joint Surg [Am]. 1995;  77 1217-1226
  • 21 Woolson S T, Delaney T J. Failure of a proximally porous-coated femoral prosthesis in revision total hip arthroplasty.  J Arthroplasty. 1995;  10 (Suppl) S22-S28
  • 22 Crawford C H, Malkani A L, Incavo S J, Morris H B, Krupp R J, Baker D. Femoral component revision using an extensively hydroxyapatite-coated stem.  J Arthroplasty. 2004;  19 8-13
  • 23 Engh Jr C A, McAuley J P, Sychterz C J, Sacco M E, Engh Sr C A. The accuracy and reproducibility of radiographic assessment of stress-shielding. A postmortem analysis.  J Bone Joint Surg [Am]. 2000;  82 1414-1420
  • 24 Sugimura T, Tohkura A. THA revision with extensively porous-coated stems. 32 hips followed 2 - 6.5 years.  Acta Orthop Scand. 1998;  69 11-13
  • 25 Incavo S J, Johnson C C, Churchill D L, Beynnon B D. Bending stiffness, torsional stability, and insertion force of cementless femoral stems.  Am J Orthop. 2001;  30 323-327
  • 26 Gie G A, Linder L, Ling R S, Simon J P, Slooff T J, Timperley A J. Impacted cancellous allografts and cement for revision total hip arthroplasty.  J Bone Joint Surg [Br]. 1993;  75 14-21
  • 27 Gokhale S, Soliman A, Dantas J P, Richardson J B, Cook F, Kuiper J H, Jones P. Variables affecting initial stability of impaction grafting for hip revision.  Clin Orthop Relat Res. 2005;  432 174-180
  • 28 Kelly S J, Incavo S J, Beynnon B. The use of a hydroxyapatite-coated primary stem in revision total hip arthroplasty.  J Arthroplasty. 2006;  21 64-71
  • 29 Kim Y H. Cementless revision hip arthroplasty using strut allografts and primary cementless proximal porous-coated prosthesis.  J Arthroplasty. 2004;  19 573-581
  • 30 Lawrence J M, Engh C A, Macalino G E. Revision total hip arthroplasty. Long-term results without cement.  Orthop Clin North Am. 1993;  24 635-644
  • 31 Goodman S B, Oh K J, Imrie S, Hwang K, Shegog M. Revision total hip arthroplasty in juvenile chronic arthritis: 17 revisions in 11 patients followed for 4 - 12 years.  Acta Orthop. 2006;  77 242-250
  • 32 Chmell M J, Scott R D, Thomas W H, Sledge C B. Total hip arthroplasty with cement for juvenile rheumatoid arthritis. Results at a minimum of ten years in patients less than thirty years old.  J Bone Joint Surg [Am]. 1997;  79 44-52
  • 33 Scott R D, Sarokhan A J, Dalziel R. Total hip and total knee arthroplasty in juvenile rheumatoid arthritis.  Clin Orthop Relat Res. 1984;  182 90-98
  • 34 Lachiewicz P F, McCaskill B, Inglis A, Ranawat C S, Rosenstein B D. Total hip arthroplasty in juvenile rheumatoid arthritis. Two to eleven-year results.  J Bone Joint Surg [Am]. 1986;  68 502-508
  • 35 Torchia M E, Klassen R A, Bianco A J. Total hip arthroplasty with cement in patients less than twenty years old. Long-term results.  J Bone Joint Surg [Am]. 1996;  78 995-1003
  • 36 Maric Z, Haynes R J. Total hip arthroplasty in juvenile rheumatoid arthritis.  Clin Orthop Relat Res. 1993;  290 197-199
  • 37 Haber D, Goodman S B. Total hip arthroplasty in juvenile chronic arthritis: a consecutive series.  J Arthroplasty. 1998;  13 259-265
  • 38 Eingartner C, Heigele T, Dieter J, Winter E, Weise K. Long-term results with the Bicontact system - aspects to investigate and to learn from.  Int Orthop. 2003;  27 (Suppl 1) S11-S15
  • 39 Eingartner C, Volkmann R, Winter E, Maurer F, Sauer G, Weller S, Weise K. Results of an uncemented straight femoral shaft prosthesis after 9 years of follow-up.  J Arthroplasty. 2000;  15 440-447
  • 40 Weller S. Fifteen years of experience with the Bicontact hip endoprosthesis system - the past, the present, the future. What has been achieved?.  Int Orthop. 2003;  27 (Suppl 1) S2-S6
  • 41 Proceedings of the International Bicontact Experts meeting. San Diego, California, USA, August 28, 2002.  Int Orthop. 2003;  27 (Suppl 1) S1-46
  • 42 Jager M, Endres S, Wilke A. [Total hip replacement in childhood, adolescence and young patients: a review of the literature] Hüftgelenkersatz im Kindes-, Jugend- und frühen Erwachsenenalter: Eine Literaturübersicht.  Z Orthop Ihre Grenzgeb. 2004;  142 194-212
  • 43 Temmerman O P, Raijmakers P G, Berkhof J, Hoekstra O S, Teule G J, Heyligers I C. Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis: a meta-analysis.  J Bone Joint Surg [Br]. 2005;  87 781-785

Dr. MD Fritz Thorey

Orthopädische Klinik
Medizinische Hochschule Hannover

Anna-von-Borries-Straße 1 - 7

30625 Hannover

Germany

Phone: + 49 5 11 5 35 45 45

Fax: + 49 5 11 5 35 46 83

Email: fritz.thorey@annastift.de

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