Finger Logan E, Gong Matthew F, Mirvish Asher, Gabrielli Alexandra S, Tafti Ahmad P, O'Malley Michael J, Klatt Brian A, Plate Johannes F
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Arthroplast Today. 2024 Dec 14;31:101582. doi: 10.1016/j.artd.2024.101582. eCollection 2025 Feb.
Improvements in cementless total hip arthroplasty have been directed at optimizing osseointegration of the femoral implant to reduce aseptic loosening rates. Stem design plays a critical role in the performance of these implants. Given the increase in new stem designs and the creation of an updated classification system, improved understanding of the outcomes of each stem type is warranted. The purpose of this study was to determine overall revision rates based on stem design and proprietary model.
Joint registry data on the reported overall cases and revisions for each cementless stem brand were collected from the annual reports of the American Joint Replacement Registry (2021), United Kingdom National Joint Registry (2021), New Zealand Joint Registry (2020), and Australian Orthopaedic Association National Joint Replacement Registry (2021). Each individual stem brand was classified into a stem type derived from the classification system described by Radaelli et al.
The most utilized stem types were (1) type B2 stems, (2) type A stems, and (3) type C1 stems. The most utilized stem models were the (1) Corail stem (B2), (2) Accolade II (type A), and (3) Taperloc 133 (type A). The highest and lowest overall revision rates observed were in the type B1 stems (8.09%) and type C3 stems (1.12%), respectively. The 3 stem models with the highest overall revision rates were the Synergy HA stem (9.04%), CBC stem (8.59%), and CLS stem (7.96%). The 3 stems with the lowest respective overall revision rates were the C2 stem (0.00%, 0 of 933 cases), Actis Duofix (0.59%), and VerSys stem (0.89%).
Based on consolidated large registry data, some cementless femoral stem types and models appear to perform better than others when compared on the basis of stem design.
非骨水泥型全髋关节置换术的改进旨在优化股骨植入物的骨整合，以降低无菌性松动率。柄部设计在这些植入物的性能中起着关键作用。鉴于新型柄部设计的增加以及更新分类系统的创建，有必要更好地了解每种柄部类型的结果。本研究的目的是根据柄部设计和专有型号确定总体翻修率。
从美国关节置换注册中心（2021年）、英国国家关节注册中心（2021年）、新西兰关节注册中心（2020年）和澳大利亚骨科协会国家关节置换注册中心（2021年）的年度报告中收集了每种非骨水泥柄部品牌报告的总体病例和翻修病例的关节注册数据。每个单独的柄部品牌被归类为源自拉代利等人描述的分类系统的柄部类型。
使用最多的柄部类型为：（1）B2型柄部，（2）A型柄部，（3）C1型柄部。使用最多的柄部型号为：（1）Corail柄部（B2型），（2）Accolade II（A型），（3）Taperloc 133（A型）。观察到的总体翻修率最高和最低的分别是B1型柄部（8.09%）和C3型柄部（1.12%）。总体翻修率最高的3种柄部型号是Synergy HA柄部（9.04%）、CBC柄部（8.59%）和CLS柄部（7.96%）。总体翻修率各自最低的3种柄部是C2柄部（0.00%，933例中0例）、Actis Duofix（0.59%）和VerSys柄部（0.89%）。
基于整合的大型注册数据，在柄部设计的基础上进行比较时，一些非骨水泥型股骨干柄部类型和型号似乎比其他类型表现更好。
