We have carried out a long-term survival analysis of a prospective, randomised trail comparing cemented with
The aim of this prospective randomised study
was to compare the clinical and radiological results of a cemented
all-polyethylene Ultima acetabular component with those of a cementless
porous-coated acetabular component (PFC) following total hip replacement
(THR). A total of 287 patients received either a polyethylene acetabular
component (group A) or a cobalt–chromium porous-coated component
(group B) with an identical cemented femoral component and 28 mm
cobalt-chromium head, thus making it the largest study of its type.
Patients were evaluated radiologically and clinically using the
Harris hip score (HHS). Group A comprised 183 patients (73 male,
110 female) with a mean age of
71.3 years (55 to 89). Group B comprised 104 patients (48 male,
56 female) with a mean age of 69.8 years (56 to 89). A total of
16 patients (13 in Group A, three in Group B) did not have post-operative
data for analysis. The mean follow-up in group A was 7.52 years
(0.4 to 15.0) and in Group B 7.87 years (0.5 to 14.0). At final follow-up the mean HHS was similar between groups A
and B (74.5 (25 to 100) and 78.0 (37 to 100), respectively; p =
0.068). The total number of revisions for any cause was 28, 17 of
which were in group A and 11 in group B. The ten-year survivorship
was 86.8% (95% confidence interval (CI) 78.4 to 92.1) and 89.2%
(95% CI 78.3 to 94.8) for groups A and B, respectively (log-rank
p-value = 0.938). A total of 20 cemented and two
Early implants for total knee replacement were fixed to bone with cement. No firm scientific reason has been given for the introduction of
We reviewed the long-term results at ten to 12 years of 118 total hip replacements in 109 patients using a second-generation hemispherical
We selected randomly a consecutive series of 162 patients requiring hip replacement to receive either a
Although about 200 000
The membranes surrounding seven loose
We evaluated 535 consecutive primary
Removal of well-fixed,
Aims. To evaluate the hypothesis that failed osteosynthesis of periprosthetic
Vancouver type B1 fractures can be treated successfully with stem
revision using a transfemoral approach and a
The long-term survival of the
The purpose of this study was to compare the
amount of acetabular bone removed during hip resurfacing (HR) and cementless
total hip replacement (THR), after controlling for the diameter
of the patient’s native femoral head. Based on a power analysis,
64 consecutive patients (68 hips) undergoing HR or THR were prospectively
enrolled in the study. The following data were recorded intra-operatively:
the diameter of the native femoral head, the largest reamer used,
the final size of the acetabular component, the size of the prosthetic
femoral head and whether a decision was made to increase the size
of the acetabular component in order to accommodate a larger prosthetic femoral
head. Results were compared using two-sided, independent samples
Student’s t-tests. A statistically significant
difference was seen in the mean ratio of the size of the acetabular
component to the diameter of the native femoral head (HR: 1.05 (. sd. 0.04) versus THR:
1.09 (. sd. 0.05); p <
0.001) and largest acetabular reamer
used to the diameter of the native femoral head (HR: 1.03 (. sd. 0.04) versus THR:
1.09 (. sd. 0.05); p <
0.001). The ratios varied minimally
when the groups were subdivided by gender, age and obesity. The
decision to increase the size of the acetabular component to accommodate
a larger femoral head occurred more often in the THR group (27% versus 9%).
Despite the emphasis on avoiding damage to the femoral neck during
HR, the ratio of the size of the acetabular component to the diameter
of the native femoral head was larger in
The incidence of deep vein thrombosis in 244 patients who had total knee replacement has been studied. In 120 the prosthesis was cemented and in 124 it was
Four hundred and fifteen patients with
We implanted 300 uncoated
We implanted 51 Metal-Cancellous
We performed a prospective study of 54 patients (76 knees) who underwent Osteonics series 3000 cruciate-retaining cementless total knee arthroplasty between December 1990 and June 1993. Five patients (seven knees) were lost to follow-up (90.7% completion). One patient required revision at 10.5 years after operation. The rate of survival was 100% at ten years and 96.7% at 13 years. The mean ten-year knee and function scores were 79 and 59 respectively. Both were significantly better than the pre-operative scores. The range of movement also improved. Although a radiolucent line around the tibial component enlarged in six knees (20.7%) at ten years, the clinical outcome was generally good. In a patient who died after 5.5 years, post-mortem examination of the knee showed no bony ingrowth into the tibial component. Despite poor bony ingrowth, press-fit fixation was satisfactory and good results can be obtained with this
Our aim in this prospective study was to compare the bone mineral density (BMD) around