Radiographic fit and fill analysis of a new second-generation proximally coated cementless stem compared to its predicate design.

The purpose of this study was to compare in vivo fit and fill analysis of a new second-generation proximally coated cementless stem compared to its predicate design. This prospective trial of 100 total hip arthroplasties compared specific radiographic "Fit and Fill" parameters between the two designs. Fit type was assessed by comparing the type of canal fill. Post-operative fill parameters such as mean stem-to-canal ratios and mean minimum and maximum gaps between the stems to the cortical bone in different sections and areas were compared. A significantly higher proportion of the second-generation stems had Type I fit (82% vs. 54%), had better stem to canal fill ratio in the middle (90.6% vs. 85.3%) and distal sections (88.1% vs. 78.6%) compared to the older design. The new second-generation stem design had a significantly better canal fit and distal canal fill in the medial and lateral portions.

The outcomes of hip resurfacing compared to standard primary total hip arthroplasty in Men.

BACKGROUND: The purpose of this study was to evaluate the clinical and radiographic outcomes of hip resurfacing patients and compare them to standard primary total hip arthroplasty procedures performed during the same period of time. METHODS: One hundred and fourteen consecutive men who had a mean age of 50 years (range, 20 to 85 years) and who had undergone 120 hip resurfacing arthroplasties between 2007 and 2009 were compared to 117 consecutive men (120 hips) who had undergone a standard total hip arthroplasty during the same time period. The mean follow-up was 42 months (range, 24 to 55 months) for both groups. Outcomes evaluated included implant survivorship, hip scores, activity levels, and complication rates. RESULTS: In the resurfacing hip arthroplasty cohort, implant survivorship was 98% with two patients requiring a revision surgery one for femoral neck fracture and another for femoral head loosening. In comparison, implant survivorship was 99% in the standard total hip arthroplasty cohort, with 1 revision due to peri-prosthetic fracture which was successfully treated with a femoral component revision. In the resurfacing and standard hip arthroplasty cohorts, the mean post-operative Harris hip scores had improved to 96 and 94 points, respectively and were statistically similar. The resurfacing cohort had achieved a significantly higher mean post-operative University of California Activity Score (6.7 versus 5 points). There were no differences in the complication rates between the two cohorts. CONCLUSION: When patients meet the appropriate selection criteria in the hands of experienced and high-volume arthroplasty surgeons, hip resurfacing provides excellent results at short- to mid-term follow-up.

Outcomes of primary total hip arthroplasty in systemic lupus erythematosus with a proximally-coated cementless stem.

The purpose of this study was to compare the outcomes of total hip arthroplasty (THA) in systemic lupus erythematosus (SLE) compared to a cohort of osteonecrosis patients who did not have this disease. Between 2001 and 2008, 60 THAs in 44 SLE patients who had a mean age of 42 years (range, 18 to 87 years) and a mean follow-up of 7 years (range, 4 to 11 years) were evaluated. These SLE patients were compared to a cohort of 82 THAs in 70 osteonecrosis patients who did not have this disease. Outcomes evaluated included implant survivorship, Harris hip scores, complications, as well as radiographic results. There was no significant difference in implant survivorship (98% vs. 97.5%), Harris hip score (87 vs. 88 points) and complications (1.7% versus 2.4%) between the SLE and the comparison cohort. The authors believe that SLE does not negatively affect the outcomes of primary total hip arthroplasty at mid-term follow-up.