12-Year Results with the Cementless Bicontact SD Stem in Dysplastic and Narrow Femoral Bone Conditions

Abstract

Aim: The aim of the study was the evaluation of the medium- to long-term results of the cementless Bicontact SD hip arthroplasty, which was designed specially for narrow femoral medullary cavities. Method: From February 1992 to December 1996 115 patients (123 joints) were treated with a Bicontact SD stem and various cup implants through a posterior approach. In one third of cases, the indication was dysplastic osteoarthritis of various degrees of severity. Results: Between November 2006 and May 2007 90 patients (98 hip joints) were followed up in a retrospective study after an average of 12.2 (10.1 - 15.1) years. The average Harris Hip Score was 93 (60 - 100) points and the Merle d'Aubigné score was 16.7 (5 - 18) points. A stem implant had to be regarded as loosened according to radiological criteria. One patient died 7 days postoperatively of a pulmonary embolism. Conclusion: The clinical and radiological results confirmed the proximal fixation concept in dysplastic femurs and narrow medullary cavities.

hip arthroplasty - dyplasia - narrow femoral bone conditions - cementless

References

• 1 Argenson J N, Ryembault E, Flecher X, Brassart N, Parratte S, Aubaniac J M. Three-dimensional anatomy of the hip in osteoarthritis after developmental dysplasia.  J Bone Joint Surg [Br]. 2005;  87 1192-1196
• 2 Badhe N P, Quinnell R C, Howards P W. The uncemented Bi-Contact total hip arthroplasty.  J Arthroplasty. 2002;  17 896-901
• 3 Burt C F, Garvin K L, Otterberg E T, Jardon O M. A femoral component inserted without cement in total hip arthroplasty. A study of the Tri-Lock component with an average ten-year duration of follow-up.  J Bone Joint Surg [Am]. 1998;  80 952-960
• 4 Brooker A F, Bowerman J W, Robinson R A. et al . Ectopic ossification following total hip replacement. Incidence and a method of classification.  J Bone Joint Surg [Am]. 1973;  55 1629
• 5 Callaghan MD J J, Templeton J E, Liu S S, Pedersen D R, Goetz D D, Sullivan P M, Johnston R C. Results of Charnley total hip arthroplasty at a minimum of thirty years.  J Bone Joint Surg [Am]. 2004;  86 690-695
• 6 Cameron H U, Lee O B, Chou H. Total hip arthroplasty in patients with deficient bone stock and small femoral canals.  J Arthroplasty. 2003;  18 35-40
• 7 Crowe J F, Mani V J, Ranawat C S. Total hip replacement in congenital dislocation and dysplasia of the hip.  J Bone Joint Surg [Am]. 1979;  61 15-23
• 8 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
• 9 Erdemli B, Yilmaz C, Atalar H, Guzel B, Cetin I. Total hip arthroplasty in developmental high dislocation of the hip.  J Arthroplasty. 2005;  20 1021-1028
• 10 Eskelinen A, Helenius I, Remes V, Ylinen P, Tallroth K, Paavilainen T. Cementless total hip arthroplasty in patients with high congenital hip dislocation.  J Bone Joint Surg [Am]. 2006;  88 80-91
• 11 Fayard J P, Chalencon F, Passot J D, Latour L D, Edorh G. Ten-year results of ALIZE acetabular cup with hydroxyapatite coating and AURA hydroxyapatite-coated stem in total hip arthroplasty.  J Arthroplasty. 2006;  21 1021-1025
• 12 Flamme C H, Wirth C J, Stukenborg-Colsman C. [Characteristics of the learning curve in total hip endoprosthesis exemplified by the BiContact prosthesis] Charakteristik der Lernkurve bei der Hüfttotalendoprothese am Beispiel der Bicontact-Prothese.  Z Orthop. 2001;  139 189-193
• 13 Grübl A, Chiari C, Giurea A, Gruber M, Kaider A, Marker M, Zehetgruber H, Gottsauner-Wolf F. Cementless total hip arthroplasty with the Rectangular Titanium Zweymüller Stem. A concise follow-up, at a minimum of fifteen years, of a previous report.  J Bone Joint Surg [Am]. 2006;  88 2210-2215
• 14 Gruen T A, McNeice G M, Amstutz H C. “Modes of failure” of cemented stem-type femoral components. A radiographic analysis of loosening.  Clin Orthop. 1979;  141 17-27
• 15 Ha Y C, Koo K H, Jeong S T, Yoo J J, Kim Y M, Kim H J. Cementless alumina-on-alumina total hip arthroplasty in patients younger than 50 years. A 5-year minimum follow-up study.  J Arthroplasty. 2007;  22 184-188
• 16 Harris W H. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by Mold arthroplasty. An end result study using a new method of result evaluation.  J Bone Joint Surg [Am]. 1969;  51 737-755
• 17 Hartofilakidi G, Karachalios T. Total hip arthroplasty for congenital hip disease.  J Bone Joint Surg [Am]. 2004;  86 242-250
• 18 Hartwig C H, Willms R, Braunschweig R. Diagnostik der gelockerten Hüftendoprothese.  Orthop Praxis. 1994;  30 136-142
• 19 Hendrich C, Engelmaier F, Mehling I, Sauer U, Kirschner S, Martell J M. Cementless acetabular reconstruction and structural bone-grafting in dysplastic hips. Surgical technique.  J Bone Joint Surg [Am]. 2007;  89 (Suppl 2) 54-67
• 20 Johnston R C, Fitzgerald R H, Harris W H, Poss R, Muller M E, Sledge C B. Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results.  J Bone Joint Surg [Am]. 1990;  72 161-168
• 21 Kaplan E L, Meier P. Nonparametric estimation from incomplete observations.  J Am Stat Assoc. 1958;  53 457-481
• 22 Kearns S R, Jamal B, Rorabeck C H, Bourne R B. Factors affecting survival of uncemented total hip arthroplasty in patients 50 years or younger.  Clin Ortop Relat Res. 2006;  453 103-109
• 23 Kerboull M, Hamadouche M, Kerboull L. Total hip arthroplasty for crowe type IV developmental hip dysplasia. A long-term follow-up study.  J Arthroplasty. 2001;  16 (Suppl 1) 170-176
• 24 Lee G Y, Srivastava A, D'Lima D D, Pulido P A, Colwell Jr C W. Hydroxyapatite-coated femoral stem survivorship at 10 years.  J Arthroplasty. 2005;  20 (Suppl 3) 57-62
• 25 Lombardi A V, Mallory T H, Eberle R W, Mitchell M B, Lefkowitz M S, Williams J R. Failure of intraoperatively customized non-porous femoral components inserted without cement in total hip arthroplasty.  J Bone Joint Surg [Am]. 1995;  77 1836-1844
• 26 Marshall A D, Mokris J G, Reitman R D, Dandar A, Mauerhan D R. Cementless titanium tapered-wedge femoral stem. 10- to 15-year follow-up.  J Arthroplasty. 2004;  19 546-552
• 27 McLaughlin J R, Lee K R. Total hip arthroplasty with an uncemented femoral component. Excellent results at ten-year follow-up.  J Bone Joint Surg [Br]. 1997;  79 900-907
• 28 Meding J B, Keating E M, Ritter M A, Faris P M, Berend M E. Minimum ten-year follow-up of a straight-stemmed, plasma-sprayed, titanium-alloy, uncemented femoral component in primary total hip arthroplasty.  J Bone Joint Surg [Am]. 2004;  86 92-97
• 29 Merle d'Aubigné R. Reposition with arthroplasty for congenital dislocation of the hip in adults.  J Bone Joint Surg [Br]. 1952;  34 22-29
• 30 Perka C, Fischer U, Taylor W R, Matziolis G. Developmental hip dysplasia treated with total hip arthroplasty with a straight stem and a threaded cup.  J Bone Joint Surg [Am]. 2004;  86 312-319
• 31 Petsatodes G E, Christoforides J E, Papadopoulos P P, Christodoulou A G, Karataglis D, Pournaras J D. Primary total-hip arthroplasty with the Autophor 900-S fully porous coated stem in young patients. Seven to seventeen years of follow-up.  J Arthroplasty. 2005;  20 436-442
• 32 Pieringer H, Auersperg V, Böhler N. Long-term results of the cementless ALLOCLASSIC hip arthroplasty system using a 28-mm ceramic head.  J Arthroplasty. 2006;  21 967-974
• 33 Pospischill M, Knahr K. Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem. Follow-up for ten to 17 years.  J Bone Joint Surg [Br]. 2005;  87 1210-1215
• 34 Sakai T, Sugano N, Ohzono K, Lee S B, Nishii T. The custom femoral component is an effective option for congenital hip dysplasia.  Clin Orthop Relat Res. 2006;  451 146-153
• 35 Surdam J W, Archibeck M J, Schultz Jr S C, Junick D W, White Jr R E. A second-generation cementless total hip arthroplasty. Mean 9-year results.  J Arthroplasty. 2007;  22 204-209
• 36 Vervest T M, Anderson P G, van Hout F, Wapstra F H, Louwerse R T, Koetsier J W. Ten to twelve-year results with the Zweymüller cementless total hip prosthesis.  J Arthroplasty. 2005;  20 362-368
• 37 Walker P S, Mai S F, Cobb A G, Bentley G, Hua J. Prediction of clinical outcome of THR from migration measurements on standard radiographs.  J Bone Joint Surg [Br]. 2005;  77 705-714
• 38 Warwick D. New concepts in orthopaedic thromboprophylaxis.  J Bone Joint Surg [Br]. 2004;  86 788-792
• 39 Wick M, Lester D K. Radiological Changes in second- and third-generation Zweymüller stems.  J Bone Joint Surg [Br]. 2004;  86 1108-1114
• 40 Yahiro M A, Gantenberg J B, Nelson R, Lu H T, Mishra N K. Comparison of the results of cemented, porous-ingrowth, and threaded acetabular cup fixation. A meta-analysis of the orthopaedic literature.  J Arthroplasty. 1995;  10 339-350
• 41 Yoon K S, Kim H J, Lee J H, Kang S B, Seong N H, Koo K H. A randomized clinical trial of cementless femoral stems with and without hydroxyapatite/tricalcium-phosphate coating. An 8- to 12-year follow-up study.  J Arthroplasty. 2007;  22 504-508