Mid- and long-term effectiveness of total hip arthroplasty with Ribbed femoral stem prosthesis in 354 cases_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Tao , XIE Jie , HU Yihe , AN Senbo ,  WANG Long

Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha Hunan, 410008, P.R.China;

Corresponding author：

WANG Long, Email: dr_wanglong@csu.edu.cn

Keywords：

Total hip arthroplasty; Ribbed femoral stem prosthesis; cementless prosthesis

DOI：

10.7507/1002-1892.201901124

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the mid- and long-term effectiveness of total hip arthroplasty (THA) with Ribbed femoral stem prosthesis.Methods A clinical data of 354 patients (384 hips) with hip disease who underwent THA with Ribbed femoral stem prostheses between October 2006 and May 2016 was retrospectively analyzed. There were 171 males and 183 females, with an average age of 53.4 years (range, 20-82 years). There were 324 cases of single hip and 30 cases of bilateral hips. The cause of THA included the avascular necrosis of the femoral head in 151 cases (159 hips), hip osteoarthritis in 134 cases (136 hips), rheumatoid arthritis in 43 cases (43 hips), ankylosing spondylitis in 20 cases (40 hips), and trauma in 6 cases (6 hips). The Harris score of total 354 patients before operation was 42.34±8.89. Harris scores were used to evaluate hip function after operation. X-ray films were used to determine the length of the lower limb, the radiolucent line on the femur side, the stability of the prosthesis, and the occurrence of stress shielding.Results The incisions healed by first intention. All patients were followed up 2-11 years with an average of 7.4 years. The Harris score at last follow-up was 80.52±7.61, which significantly increased when compared with preoperative score (t=134.804, P=0.000). Two cases (2 hips) of prosthetic infections, 3 cases (3 hips) of prothesis loosening, and 4 cases (4 hips) of periprosthetic fractures, and 48 cases (48 hips) of mild to moderate thigh pain occurred after operation. X-ray films showed 76 cases (78 hips) with radiolucent lines on the femur side and stress shielding. According to the Engh’s method, there were 364 hips of bone ingrowth, 15 hips of fibrosis ingrowth, and 5 hips of prosthesis instability. The femoral stem subsidence occurred in 25 cases (25 hips), and the difference in leg length discrepancy was more than 10 mm in 5 patients.Conclusion THA with Ribbed femoral stem prosthesis can achieve satisfactory effectiveness with good initial stability and rapid bone growth. The incidence of stress shielding is relatively high, but the stress shielding has no significant impact on the mid- and long-term survival rate and effectiveness of femoral prosthesis.

Citation： YANG Tao, XIE Jie, HU Yihe, AN Senbo, WANG Long. Mid- and long-term effectiveness of total hip arthroplasty with Ribbed femoral stem prosthesis in 354 cases. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(9): 1116-1120. doi: 10.7507/1002-1892.201901124 Copy

1.	Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597): 1508-1519.
2.	Kuijpers MFL, Hannink G, van Steenbergen LN, et al. Total hip arthroplasty in young patients in the Netherlands: trend analysis of >19 000 primary hip replacements in the Dutch arthroplasty register. J Arthroplasty, 2018, 33(12): 3704-3711.
3.	胡懿郃, 朱勇, 龙文荣, 等. 保留股骨颈全髋关节置换的早期疗效分析. 中国修复重建外科杂志, 2004, 18(5): 383-385.
4.	黄和涛, 潘建科, 谢辉, 等. 保留股骨颈假体全髋关节置换: 与传统设计假体置换效果的区别? 中国组织工程研究, 2017, 21(31): 5054-5059.
5.	Li M, Hu Y, Xie J. Analysis of the complications of the collum femoris preserving (CFP) prostheses. Acta Orthop Traumatol Turc, 2014, 48(6): 623-627.
6.	Morscher EW. Failures and successes in total hip replacement—why good ideas may not work. Scand J Surg, 2003, 92(2): 113-120.
7.	Li M, Xu C, Xie J, et al. Comparison of collum femoris-preserving stems and ribbed stems in primary total hip arthroplasty. J Orthop Surg Res, 2018, 13(1): 271.
8.	Gruen TA, McNeice GM, Amstutz HC. " Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141): 17-27.
9.	Johnston RC, Fitzgerald RH Jr, Harris WH, et al. Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg (Am), 1990, 72(2): 161-168.
10.	Engh CA, McGovern TF, Bobyn JD, et al. A quantitative evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty. J Bone Joint Surg (Am), 1992, 74(7): 1009-1020.
11.	Nishino T, Mishima H, Kawamura H, et al. Follow-up results of 10-12 years after total hip arthroplasty using cementless tapered stem-frequency of severe stress shielding with synergy stem in Japanese patients. J Arthroplasty, 2013, 28(10): 1736-1740.
12.	毛宾尧, 应忠追, 李新春, 等. 67 例全髋关节置换术后 13 年的随访结果. 中华关节外科杂志(电子版), 2008, 2(5): 505-509.
13.	周勇刚, 王岩, 陈继营, 等. 解剖型非骨水泥固定股骨假体在股骨头坏死治疗中的应用. 中国矫形外科杂志, 2003, 11(23): 1597-1599.
14.	刘明, 王岩, 陈继营, 等. 1436 髋 Ribbed 假体单中心应用分析. 中国矫形外科杂志, 2008, 16(14): 1051-1053.
15.	林均馨, 张鹏, 刘玉江, 等. 148 髋 Ribbed 假体全髋关节置换的临床研究. 中国骨与关节外科, 2010, 3(1): 57-58.
16.	史庆轩, 李佩佳, 孙磊, 等. 662 髋 Ribbed 假体中远期临床疗效观察. 中国矫形外科杂志, 2012, 20(15): 1370-1373.
17.	Fitch DA, Ancarani C, Bordini B. Long-term survivorship and complication rate comparison of a cementless modular stem and cementless fixed neck stems for primary total hip replacement. Int Orthop, 2015, 39(9): 1827-1832.
18.	Kumar V, Sharma S, James J, et al. Total hip replacement through a posterior approach using a 22 mm diameter femoral head: the role of the transverse acetabular ligament and capsular repair in reducing the rate of dislocation. Bone Joint J, 2014, 96-B(9): 1202-1206.
19.	Castano-Betancourt MC, Fruschein Annichino R, de Azevedo E Souza Muhoz M, et al. Identification of high-risk groups for complication after arthroplasty: predictive value of patient’s related risk factors. J Orthop Surg Res, 2018, 13(1): 328.
20.	Lee YK, Park CH, Kim KC, et al. Frequency and associated factor of atypical periprosthetic femoral fracture after hip arthroplasty. Injury, 2018, 49(12): 2264-2268.
21.	Lindahl H, Oden A, Garellick G, et al. The excess mortality due to periprosthetic femur fracture. A study from the Swedish national hip arthroplasty register. Bone, 2007, 40(5): 1294-1298.
22.	Lindahl H, Malchau H, Herberts P, et al. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty, 2005, 20(7): 857-865.
23.	Arora A, Song Y, Chun L, et al. The role of the TH1 and TH2 immune responses in loosening and osteolysis of cemented total hip replacements. J Biomed Mater Res A, 2003, 64(4): 693-697.
24.	Hessler R, Lunebourg A, Fisher JF, et al. Prosthetic hip infection due to Listeria monocytogenes: review of the literature and case report. Rev Med Suisse, 2014, 10(450): 2164-2167.
25.	张先龙, 沈灏, 王俏杰. 髋关节假体感染的临床和基础研究进展. 中华关节外科杂志(电子版), 2014, 8(1): 1-3.
26.	顾航宇, 李庭, 赵春鹏, 等. 髋关节假体周围骨折的治疗现状及进展. 骨科临床与研究杂志, 2018, 3(2): 119-128.

1. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597): 1508-1519.
2. Kuijpers MFL, Hannink G, van Steenbergen LN, et al. Total hip arthroplasty in young patients in the Netherlands: trend analysis of >19 000 primary hip replacements in the Dutch arthroplasty register. J Arthroplasty, 2018, 33(12): 3704-3711.
3. 胡懿郃, 朱勇, 龙文荣, 等. 保留股骨颈全髋关节置换的早期疗效分析. 中国修复重建外科杂志, 2004, 18(5): 383-385.
4. 黄和涛, 潘建科, 谢辉, 等. 保留股骨颈假体全髋关节置换: 与传统设计假体置换效果的区别? 中国组织工程研究, 2017, 21(31): 5054-5059.
5. Li M, Hu Y, Xie J. Analysis of the complications of the collum femoris preserving (CFP) prostheses. Acta Orthop Traumatol Turc, 2014, 48(6): 623-627.
6. Morscher EW. Failures and successes in total hip replacement—why good ideas may not work. Scand J Surg, 2003, 92(2): 113-120.
7. Li M, Xu C, Xie J, et al. Comparison of collum femoris-preserving stems and ribbed stems in primary total hip arthroplasty. J Orthop Surg Res, 2018, 13(1): 271.
8. Gruen TA, McNeice GM, Amstutz HC. " Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141): 17-27.
9. Johnston RC, Fitzgerald RH Jr, Harris WH, et al. Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg (Am), 1990, 72(2): 161-168.
10. Engh CA, McGovern TF, Bobyn JD, et al. A quantitative evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty. J Bone Joint Surg (Am), 1992, 74(7): 1009-1020.
11. Nishino T, Mishima H, Kawamura H, et al. Follow-up results of 10-12 years after total hip arthroplasty using cementless tapered stem-frequency of severe stress shielding with synergy stem in Japanese patients. J Arthroplasty, 2013, 28(10): 1736-1740.
12. 毛宾尧, 应忠追, 李新春, 等. 67 例全髋关节置换术后 13 年的随访结果. 中华关节外科杂志(电子版), 2008, 2(5): 505-509.
13. 周勇刚, 王岩, 陈继营, 等. 解剖型非骨水泥固定股骨假体在股骨头坏死治疗中的应用. 中国矫形外科杂志, 2003, 11(23): 1597-1599.
14. 刘明, 王岩, 陈继营, 等. 1436 髋 Ribbed 假体单中心应用分析. 中国矫形外科杂志, 2008, 16(14): 1051-1053.
15. 林均馨, 张鹏, 刘玉江, 等. 148 髋 Ribbed 假体全髋关节置换的临床研究. 中国骨与关节外科, 2010, 3(1): 57-58.
16. 史庆轩, 李佩佳, 孙磊, 等. 662 髋 Ribbed 假体中远期临床疗效观察. 中国矫形外科杂志, 2012, 20(15): 1370-1373.
17. Fitch DA, Ancarani C, Bordini B. Long-term survivorship and complication rate comparison of a cementless modular stem and cementless fixed neck stems for primary total hip replacement. Int Orthop, 2015, 39(9): 1827-1832.
18. Kumar V, Sharma S, James J, et al. Total hip replacement through a posterior approach using a 22 mm diameter femoral head: the role of the transverse acetabular ligament and capsular repair in reducing the rate of dislocation. Bone Joint J, 2014, 96-B(9): 1202-1206.
19. Castano-Betancourt MC, Fruschein Annichino R, de Azevedo E Souza Muhoz M, et al. Identification of high-risk groups for complication after arthroplasty: predictive value of patient’s related risk factors. J Orthop Surg Res, 2018, 13(1): 328.
20. Lee YK, Park CH, Kim KC, et al. Frequency and associated factor of atypical periprosthetic femoral fracture after hip arthroplasty. Injury, 2018, 49(12): 2264-2268.
21. Lindahl H, Oden A, Garellick G, et al. The excess mortality due to periprosthetic femur fracture. A study from the Swedish national hip arthroplasty register. Bone, 2007, 40(5): 1294-1298.
22. Lindahl H, Malchau H, Herberts P, et al. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty, 2005, 20(7): 857-865.
23. Arora A, Song Y, Chun L, et al. The role of the TH1 and TH2 immune responses in loosening and osteolysis of cemented total hip replacements. J Biomed Mater Res A, 2003, 64(4): 693-697.
24. Hessler R, Lunebourg A, Fisher JF, et al. Prosthetic hip infection due to Listeria monocytogenes: review of the literature and case report. Rev Med Suisse, 2014, 10(450): 2164-2167.
25. 张先龙, 沈灏, 王俏杰. 髋关节假体感染的临床和基础研究进展. 中华关节外科杂志(电子版), 2014, 8(1): 1-3.
26. 顾航宇, 李庭, 赵春鹏, 等. 髋关节假体周围骨折的治疗现状及进展. 骨科临床与研究杂志, 2018, 3(2): 119-128.

Chinese Journal of Reparative and Reconstructive Surgery

Mid- and long-term effectiveness of total hip arthroplasty with Ribbed femoral stem prosthesis in 354 cases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content