Comparison of Clinical Efficacy Between Modular Cementless Stem Prostheses and Coated Cementless Long-Stem Prostheses on Bone Defect in Hip Revision Arthroplasty
Huibin Li, Fang Chen, Zhe Wang, Qian Chen
Department of Burn and Plastic Surgery, People's Hospital of Linyi, Linyi, Shandong, China (mainland)
Med Sci Monit 2016; 22:670-677
The aim of this study was to investigate and compare the clinical efficacy of modular cementless stem and coated cementless long-stem prostheses in hip revision arthroplasty.
MATERIAL AND METHODS: Sixty-five patients with complete hip revision surgery data during January 2005 to March 2015 were selected from the People’s Hospital of Linyi City and randomly divided into a S-ROM group (implanted with cementless modular stem prostheses, n=32) and a SLR-PLUS group (implanted with cementless coated long-stem prostheses, n=33). Harris score was used to evaluate the hip function of the patients in order to measure the clinical efficacy of the prostheses in total hip arthroplasty. Anteroposterior pelvic radiographs and lateral pelvic radiographs were taken and each patient’s hip arthroplasty condition was recorded. Kaplan-Meier method was applied to compare the cumulative 5-year non-revision rate between the 2 prostheses and log-rank method was used to inspect the statistical data.
RESULTS: The Harris scores of both the S-ROM group and the SLR-PLUS group were significantly higher at 12 months after the operation than those before the operation (both P<0.05). The Harris scores of the patients with type I/II bone defects in the S-ROM group were not significantly different from those of the same types in the SLR-PLUS group at all time points (all P>0.05), while the Harris scores of the patients with type IIIA/IIIB in the S-ROM group were both significantly higher than those of the same types in the SLR-PLUS group at 3 months, 6 months, and 12 months after the operation (all P<0.05). No significant difference was found in the cumulative 5-year non-revision rate between the type I/II patients in the S-ROM group (92.31%) and the patients of the same types in the SLR-PLUS group (85.71%) (P>0.05). However, the cumulative 5-year non-revision rate of the type IIIA/IIIB patients in the S-ROM group (89.47%) was significantly different from the patients of the same types in the SLR-PLUS group (42.11%) (P<0.05).
CONCLUSIONS: The modular stem prostheses in hip revision arthroplasty were clinically more effective in the treatment of type IIIA and IIIB bone defects than the coated long-stem prostheses according to the Harris score and the cumulative 5-year non-revision rate.
Keywords: Arthroplasty, Replacement, Hip, Bone Cements, Coated Materials, Biocompatible - pharmacology, Hip - pathology, Hip Prosthesis, Postoperative Care, Preoperative Care