Details

Autor(en) / Beteiligte

• Hjorth, Mette H., MD, PhD
• Kold, Søren, MD, PhD
• Søballe, Kjeld, MD, DMSc
• Langdahl, Bente L., MD, DMSc
• Nielsen, Poul T., MD
• Christensen, Poul H., MD
• Stilling, Maiken, MD, PhD

Titel

Preparation of the Femoral Bone Cavity for Cementless Stems: Broaching vs Compaction. A Five-Year Randomized Radiostereometric Analysis and Dual Energy X-Ray Absorption Study

Ist Teil von

• The Journal of arthroplasty, 2017-06, Vol.32 (6), p.1894-1901

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Quelle

ScienceDirect

Beschreibungen/Notizen

• Abstract Background Short-term experimental and animal studies have confirmed superior fixation of cementless implants inserted with compaction compared to broaching of the cancellous bone. Methods Forty-four hips in 42 patients (19 men) were randomly operated using cementless hydroxyapatite-coated Bi-Metric stems. Patients were followed with radiostereometric analysis at baseline, 6 and 12 weeks, 1, 2, and 5 years, and measurements of periprosthetic bone mineral density at baseline, 1, 2, and 5 years. Complications during the study period and clinical outcome measures of Harris Hip Score were recorded at mean 7 years (5-8.8) after surgery. Results Absolute migrations of medio/lateral translations between the broaching group and the compaction group of mean 0.14 mm (standard deviation [SD] 0.10) vs mean 0.30 mm (SD 0.27) ( P  = .01) at 1 year, and of mean 0.13 mm (SD 0.10) vs 0.34 mm (0.31) ( P  = .01) at 5 years were different. Absolute valgus/varus rotations of mean 0.12° (SD 0.13°) in the broaching group were less than mean 0.35° (0.45°) in the compaction group ( P < .01) at 1 year, but at 5 years no difference was observed ( P  = .19). Subsidence and retroversion were similar between groups at all follow-ups ( P > .13). The compaction group had significantly less bone loss than the broaching group in Gruen zone 3 (distal-lateral to the stem) at 1 and 5 years. No further differences in bone mineral density changes were found between groups up to 5 years after surgery. Complications throughout the period and clinical outcome measures of Harris Hip Score were similar at 7 years (5-8.8) after surgery. Conclusion We found increased migration when preparing the bone with compaction compared with broaching in cementless femoral stems.