Survival of Polished Compared with Precoated Roughened Cemented Femoral Components

Lachiewicz, Paul F.; Kelley, Scott S.; Soileau, Elizabeth S.
July 2008
Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1457
Academic Journal
Background: The optimal surface finish for cemented femoral components remains controversial. The purpose of this randomized clinical trial was to compare the survival of two femoral components with similar geometry but substantially different surface finishes. Methods: During a five-year period, 201 patients (219 hips) were prospectively randomized to be treated with a total hip arthroplasty with either a polished (Ra, 0.18 to 0.3 μm) or a precoated roughened (Ra, 1.8 to 2.3 μm) cemented femoral component with similar geometry. There were no significant differences between the patient groups in terms of age, sex, weight, preoperative diagnosis, component size, or cement grade. So-called third-generation cementing techniques were used. One hundred and thirteen polished components and 106 precoated roughened components were followed for a mean of 5.3 years. Complete clinical and radiographic data were available for 134 hips at a minimum of five years (mean, 6.1 years; range, five to ten years) postoperatively. Results: In the entire cohort of 219 hips, there was no significant difference (log rank p = 0.66) in survival, with the end point defined as component removal for any reason or definite radiographic loosening, between the precoated components (96.2%; 95% confidence interval, 90.9% to 100%) and the polished components (97.1%; 95% confidence interval, 93.8% to 100%). There was a periprosthetic fracture in three hips with a polished component. Two precoated roughened components were revised because of loosening, and two polished components were revised: one because of loosening and one because of a nonunion of a periprosthetic fracture. There was no significant difference between the groups with regard to the Harris hip scores or the clinical results. There was also no significant difference with regard to the presence or number of bone-cement radiolucent lines. Conclusions: Kaplan-Meier survival analysis showed no significant differences between two types of cemented femoral components with similar geometry but substantially different surface finishes at seven years. In the patient population selected for treatment with a cemented femoral component, the surface finish may not be a crucial factor affecting component survival at a minimum of five years, provided that good cement technique is used.


Related Articles

  • Modes of Failure of Osteonics Constrained Tripolar Implants: A Retrospective Analysis of Forty-three Failed Implants. Olivier Guyen; David G. Lewallen; Miguel E. Cabanela // Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1553 

    Background: The Osteonics constrained tripolar implant has been one of the most commonly used options to manage recurrent instability after total hip arthroplasty. Mechanical failures were expected and have been reported. The purpose of this retrospective review was to identify the observed...

  • Posterior Capsular Repair Following Total Hip Arthroplasty: A Modified Technique. Osmani, Omar; Malkani, Arthur; Harwin, Steven F. // Orthopedics;Jun2004, Vol. 27 Issue 6, p553 

    The article presents a modified technique of exposing and repairing the posterior structure during total hip arthroplasty. Studies have demonstrated the merits of posterior capsular repair with respect to decreasing the incidence of dislocation. The technique offers excellent fixation of the hip...

  • Minimalinvasive Hüftendoprothetik - nur Trend oder schon Standard? Kappe, T.; Bieger, R.; Wernerus, D.; Reichel, H. // Der Orthopäde;Sep2011, Vol. 40 Issue 9, p774 

    Minimally invasive approaches in total hip arthroplasty are being used worldwide and continue to grow in popularity. Despite early reports of catastrophic failures, both the number of scientific publications as well as the number of orthopaedic surgeons practicing minimally invasive techniques...

  • Giant Pseudoaneurysm After Girdlestone's Excision Arthroplasty. Bowley, DM; Brinsden, MD; Halawa, M; Wilkins, DC // Internet Journal of Orthopedic Surgery;2003, Vol. 1 Issue 2, p26 

    Vascular injury is rare after hip arthroplasty. We report the occurrence of a giant pseudoaneurysm of the profunda femoris artery after excision arthroplasty of the hip. A high index of suspicion must be maintained to detect vascular injury if the limb is to be salvaged.

  • Endovascular repair of a pseudo-aneurysm of the common femoral artery after revision total hip arthroplasty. F. D’Angelo; G. Piffaretti; G. Carrafiello; M. Tozzi; R. Caronno; P. Castelli; G. Zatti // Emergency Radiology;Sep2007, Vol. 14 Issue 4, p233 

    Abstract  Vascular injuries with acute arterial haemorrhage are rare but the infrequency of these complications may make their diagnosis and treatment challenging for surgeons unfamiliar with their management. In the past, surgery or coil embolisation has been used to treat these...

  • The outcome of the cementless tapered SL-Plus stem: an analysis of arthroplasty register data. Labek, Gerold; Kovac, Simon; Levasic, Vesna; Janda, Wolfgang; Zagra, Luigi // International Orthopaedics;Jun2012, Vol. 36 Issue 6, p1149 

    Purpose: The aim of this study is to evaluate the outcome of the cementless SL-Plus stem in worldwide arthroplasty register datasets. Methods: A structured analysis was conducted the registered data about the SL-Plus stem manufactured by Smith&Nephew including published data from Australia as...

  • Hip resurfacing in patients under thirty years old: an attractive option for young and active patients. Krantz, Nicolas; Miletic, Bruno; Migaud, Henri; Girard, Julien // International Orthopaedics;Sep2012, Vol. 36 Issue 9, p1789 

    Purpose: Metal-on-metal hip resurfacing is offered as an alternative to traditional hip arthroplasty for young, active adults with advanced osteoarthritis. The concept of hip resurfacing is considered very attractive for this specific population (hard-on-hard bearing component with a large...

  • The accuracy of digital templating: a comparison of short-stem total hip arthroplasty and conventional total hip arthroplasty. Schmidutz, Florian; Steinbrück, Arnd; Wanke-Jellinek, Lorenz; Pietschmann, Matthias; Jansson, Volkmar; Fottner, Andreas // International Orthopaedics;Sep2012, Vol. 36 Issue 9, p1767 

    Purpose: Selection of the correct femoral stem size is crucial in total hip arthroplasty for an uncomplicated implantation and good initial stability. Pre-operative templating has been shown to be a valuable tool in predicting the correct implant size. For short-stem total hip arthroplasty...

  • Successful Closed Reduction of a Dislocated Constrained Total Hip Arthroplasty: A Case Report and Literature Review. Sonohata, Motoki; Waewsawangwong, Warit; Goodman, Stuart B. // Open Orthopaedics Journal;2012, Vol. 6, p211 

    Many surgeons use acetabular components with constrained polyethylene liners to improve stability after total hip arthroplasty in patients with a history of hip dislocation. Surgical treatment is generally thought to be the only available option for the dislocated constrained liner. The success...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics