RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS

I.R Chambers; D. Fender; A.W. McCaskie; P.J Gregg

doi:10.1302/0301-620X.85BSUPP_I.0850034d

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RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS

I.R Chambers
D. Fender
A.W. McCaskie
P.J Gregg

RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS

Chambers I, Fender D, McCaskie A, Gregg P. RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS. Orthop Procs. 2003;85-B(SUPP_I):34-35. doi:10.1302/0301-620X.85BSUPP_I.0850034d

Chambers, I.R, et al. “RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS.” Orthopaedic Proceedings, vol. 85-B, no. SUPP_I, 2003, pp. 34-35., https://doi.org/10.1302/0301-620X.85BSUPP_I.0850034d

Chambers, I., Fender, D., McCaskie, A., & Gregg, P. (2003). RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS. Orthopaedic Proceedings, 85-B(SUPP_I), 34-35. https://doi.org/10.1302/0301-620X.85BSUPP_I.0850034d

Chambers, I., Fender, D., McCaskie, A. and Gregg, P. (2003) “RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS.” Orthopaedic Proceedings, 85-B(SUPP_I), pp. 34-35. Available at: https://doi.org/10.1302/0301-620X.85BSUPP_I.0850034d

Chambers, I.R, D. Fender, A.W. McCaskie, and P.J Gregg. “RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS.” Orthopaedic Proceedings 85-B, no. SUPP_I (2003): 34-35. https://doi.org/10.1302/0301-620X.85BSUPP_I.0850034d

Chambers I, Fender D, McCaskie A, Gregg P. RADIOGRAPHIC FEATURES PREDICTIVE OF ASEPTIC LOOSENING OF CEMENTED CHARNLEY FEMORAL STEMS. Orthop Procs. 2003 Jan 1;85-B(SUPP_I):34-35. https://doi.org/10.1302/0301-620X.85BSUPP_I.0850034d

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Abstract

To establish whether there were features present on the initial post-operative radiographs of total hip replacements (THR) predictive of aseptic loosening.

Our data was derived from the Trent Regional Arthroplasty Study (TRAS) which is the only hip register of its kind in the country. The TRAS commenced in 1990 and has recorded clinical and operative details of all THRs in the region.

Our current study was concerned with a cohort of grossly loose THRs, identified from the five-year follow up of those patients who had undergone THR in 1990. Our cohort are those which failed specifically due to aseptic loosening and comprises those revised or listed for revision as well as a number of previously undiagnosed cases.

The post-operative radiographs were analysed, recording the following: (1) number, width and location (Gruen zone) of radiolucencies at both cement-bone and cement-prosthesis interfaces; (2) presence of stem-cortex contact; (3) width of the cement mantle in each Gruen zone; and (4) Barrack cementation grade.

Occasionally, if the initial post-operative radiograph was of poor quality, then further information was gained from the next available ones (usually at six weeks) to improve accuracy.

Comparisons were made with 60 control hips randomly generated from the same 1990 cohort but which had not failed.

Chi-squared tests were used to test the probability of obtaining the observed data by chance and odds ratios were calculated to describe relative risk of failure for different risk factors.

Hips with inadequate cementation grades (C and D) had a 9.5 times greater risk of failure compared to those with adequate cementation grades (A and B) [p< 0.0001].

We have demonstrated that the grade of cementation has a major effect on the probability of failure. This emphasises the importance of good cementing, which is particularly relevant in this era of clinical governance where there is greater accountability on the surgeon for adequate performance.

The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.