Abstract
Purpose
One of the drawbacks of cemented total hip arthroplasty (THA) is aseptic loosening after long period, major reason for which is bioinertness of PMMA bone cement. To improve longevity of THA, interface bioactive bone cement (IBBC) technique which is characterized with smearing hydroxyapatite (HA) granules just before cementation has been used in our institute.
Objective
Smooth-surfaced triple-tapered Titanium-alloy stem (T) and Exeter stem (E) have been used consecutively in the different period. Objective of the present study was thoroughly comparing two stems clinically and radiologically.
Method
The present study includes 38 hips of T and 40 hips of E. Mean postoperative follow up period was 7.7 years for T and 6.2 years for E. Radiolucent line (RL) was determined as clear line with sclerotic demarcation and cancellisation as without it.
Results
Pre- and postoperative evaluation using Merle d'Aubigné score were 8.1 (2.2, 2.2, 3.7) and 16.0 (6.0, 5.2, 4.8) points for T and, 8.1 (2.2, 2.2, 3.7) and 16.4 (6.0, 5.6, 4.8) for E, respectively. Postoperative cementing grade using Barrack's classification was classified as A for 30 hips in T and 39 hips in E, and as B for 8 hips in T and 9 hips in E. Neither osteolysis nor loosening was observed in both groups. No RL at bone-cement interface, focal osteolysisã, cement fracture was observed. Cortical hypertrophy (CH) was observed in 7 hips of T and 5 hips of E (NS). Cortical hypertrophy (CH) localized beyond stem tip was observed in all hips of T (Figure 1) and in 1 hips of E (Figure 2) (p < 0.05). Cancellisation was observed in 17 hips of T and 16 hips in E (NS).
Conclusion
The present study revealed excellent medium-term result was obtained using both stems fixed with IBBC technique. CH was observed more distally in T compared with E.
