Ten-year outcomes of cementless anatomical ...
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Article dans une revue scientifique: Article original
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Title :
Ten-year outcomes of cementless anatomical femoral implants after 3D computed tomography planning. Follow-up note.
Author(s) :
Tostain, Olivier [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Debuyzer, Emmanuel [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Benad, Kevin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Putman, Sophie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Pierache, Adeline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369
Pasquier, Gilles [Auteur]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Marrow Adiposity & Bone Lab (MABLab) - ULR 4490
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Debuyzer, Emmanuel [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Benad, Kevin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Putman, Sophie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Pierache, Adeline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Girard, Julien [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369
Pasquier, Gilles [Auteur]
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Marrow Adiposity & Bone Lab (MABLab) - ULR 4490
Journal title :
Orthopaedics & Traumatology: Surgery & Research
Abbreviated title :
Orthop Traumatol Surg Res
Publication date :
2019-06-26
ISSN :
1877-0568
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
BACKGROUND: Pre-operative 3D planning based on computed tomography (CT) imaging is used to optimise the restitution of normal hip anatomy during primary total hip arthroplasty (THA). Although CT planning has been proven ...
Show more >BACKGROUND: Pre-operative 3D planning based on computed tomography (CT) imaging is used to optimise the restitution of normal hip anatomy during primary total hip arthroplasty (THA). Although CT planning has been proven effective and reproducible, its influence on long-term THA outcomes is unknown. In this 10-year follow-up study of patients managed with the same technique of CT-planned primary anatomical THA, the objectives were to assess femoral implant survival, long-term functional outcomes, 10-year outcomes of titanium modular femoral necks, and associations with the dislocation rate. Hypothesis Pre-operative CT planning of primary THA ensures achievement of the NICE criterion of a lower than 5% femoral revision rate within 10 years. METHODS: The study included 61 patients (61 hips) managed between 2004 and 2007 by CT-planned primary THA via the posterior approach, with an uncemented anatomical femoral component (SPS , Symbios); when deemed necessary by the surgeon to restore normal anatomy, a titanium modular femoral neck was used (35/61 patients). After 10 years, 17 patients had died and 3 were lost to follow-up, leaving 41 patients with a mean age of 76 years (range, 60-91 years) for re-evaluation. Clinical outcomes were assessed by determining the Harris Hip Score (HHS) and the Postel-Merle d'Aubigné (PMA) score, which were compared to baseline values. Radiographs were evaluated using the AGORA Roentgenographic Assessment system (ARA). RESULTS: The 10-year femoral component survival rate was 96% (95%CI, 88;99%). Revision was required in 4 patients, to treat delayed peri-prosthetic fractures (n=2) or to correct initial cup malposition (n=2). No changes occurred from 2010 to last follow-up in the mean HHS (90 [95%CI, 84;95] and 91 [95%CI, 77;96], respectively) or mean PMA score (16 [95%CI, 14;17] and 15.5 [95%CI, 14;16.5], respectively). The mean ARA score was 5.2 (range, 3-6) at last follow-up. No complications related to the use of modular femoral necks were recorded. Dislocation occurred in 2 patients, but in neither was the pre-operative plan followed during surgery. CONCLUSIONS: The SPS stem produced good 10-year clinical and radiographic outcomes. No patients experienced complications related to use of a titanium modular femoral neck. The restoration of anatomical hip geometry made possible by pre-operative CT planning provided sustained clinical improvements with a low complication rate. METHODS: IV, retrospective observational cohort study.Show less >
Show more >BACKGROUND: Pre-operative 3D planning based on computed tomography (CT) imaging is used to optimise the restitution of normal hip anatomy during primary total hip arthroplasty (THA). Although CT planning has been proven effective and reproducible, its influence on long-term THA outcomes is unknown. In this 10-year follow-up study of patients managed with the same technique of CT-planned primary anatomical THA, the objectives were to assess femoral implant survival, long-term functional outcomes, 10-year outcomes of titanium modular femoral necks, and associations with the dislocation rate. Hypothesis Pre-operative CT planning of primary THA ensures achievement of the NICE criterion of a lower than 5% femoral revision rate within 10 years. METHODS: The study included 61 patients (61 hips) managed between 2004 and 2007 by CT-planned primary THA via the posterior approach, with an uncemented anatomical femoral component (SPS , Symbios); when deemed necessary by the surgeon to restore normal anatomy, a titanium modular femoral neck was used (35/61 patients). After 10 years, 17 patients had died and 3 were lost to follow-up, leaving 41 patients with a mean age of 76 years (range, 60-91 years) for re-evaluation. Clinical outcomes were assessed by determining the Harris Hip Score (HHS) and the Postel-Merle d'Aubigné (PMA) score, which were compared to baseline values. Radiographs were evaluated using the AGORA Roentgenographic Assessment system (ARA). RESULTS: The 10-year femoral component survival rate was 96% (95%CI, 88;99%). Revision was required in 4 patients, to treat delayed peri-prosthetic fractures (n=2) or to correct initial cup malposition (n=2). No changes occurred from 2010 to last follow-up in the mean HHS (90 [95%CI, 84;95] and 91 [95%CI, 77;96], respectively) or mean PMA score (16 [95%CI, 14;17] and 15.5 [95%CI, 14;16.5], respectively). The mean ARA score was 5.2 (range, 3-6) at last follow-up. No complications related to the use of modular femoral necks were recorded. Dislocation occurred in 2 patients, but in neither was the pre-operative plan followed during surgery. CONCLUSIONS: The SPS stem produced good 10-year clinical and radiographic outcomes. No patients experienced complications related to use of a titanium modular femoral neck. The restoration of anatomical hip geometry made possible by pre-operative CT planning provided sustained clinical improvements with a low complication rate. METHODS: IV, retrospective observational cohort study.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Univ. Littoral Côte d’Opale
Univ. Artois
Université de Lille
Univ. Littoral Côte d’Opale
Univ. Artois
Université de Lille
Collections :
Research team(s) :
Activité Physique, Muscle, Santé (APMS)
Submission date :
2019-09-24T07:29:12Z
2021-05-20T12:55:41Z
2024-02-23T14:02:33Z
2021-05-20T12:55:41Z
2024-02-23T14:02:33Z
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