Migration of the femoral stem after impaction bone grafting: First results of an ongoing, randomised study of the exeter and elite plus femoral stems using radiostereometric analysis

We report the initial results of an ongoing randomised, prospective study on migration of the Exeter and Elite Plus femoral stems after impaction allografting, as measured by radiostereometry. Clinically, the impaction technique gave good results for both stems. The mean subsidence in the first year...

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Bibliographic Details
Published in:	Journal of bone and joint surgery. British volume Vol. 84; no. 6; pp. 825 - 831
Main Authors:	VAN DOOM, W. J, TEN HAVE, B. L. E. F, VAN BIEZEN, F. C, HOP, W. C. J, GINAI, A. Z, VERHAAR, J. A. N
Format:	Journal Article
Language:	English
Published:	London British Editorial Society of Bone and Joint Surgery 01-08-2002 British Editorial Society of Bone & Joint Surgery
Edition:	British volume
Subjects:	Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - instrumentation Biological and medical sciences Body Weights and Measures - methods Bone Remodeling Bone Transplantation Female Foreign-Body Migration - diagnostic imaging Hip Prosthesis - adverse effects Humans Male Medical sciences Middle Aged Orthopedic surgery Prospective Studies Prosthesis Failure Quality of Life Radiography Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Human Evaluation Reoperation Femur Prognosis Implant Prosthesis Migration Radiologic investigation Stereoradiography Hip Orthopedic surgery Treatment Total Graft Bone Technique
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Summary:	We report the initial results of an ongoing randomised, prospective study on migration of the Exeter and Elite Plus femoral stems after impaction allografting, as measured by radiostereometry. Clinically, the impaction technique gave good results for both stems. The mean subsidence in the first year was 1.30 mm and 0.20 mm for the Exeter and the Elite Plus stems, respectively. In the second year, the Exeter stem continued to subside further by a mean of 0.42 mm, while the Elite Plus stem did not do so. Subsidence of the Exeter stem correlated with deficiency of bone stock as graded on the Gustilo and Pasternak scale. This correlation was not found for the Elite Plus stem. None of the other parameters which were studied predisposed to subsidence. There was no significant association between the amount of subsidence and the radiological appearance of the graft for either stem. Our findings do not support the theory that radial compression, due to subsidence of the Exeter stem, is the essential stimulus for remodelling in impaction allografting.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0301-620X 2049-4394 2044-5377 2049-4408
DOI:	10.1302/0301-620X.84B6.0840825