A clinical, radiological and biomechanical study of the TARA hip prosthesis.
We reviewed 60 patients with 72 TARA (total articular replacement arthroplasty) resurfacing hip prostheses. To analyse the behaviour of the femoral component a radiographic study was done and a two-dimensional finite element model was constructed. The stem of the femoral component plays a role in the load transfer mechanism. Stress shielding is seen in the proximal femur but depends on the interface conditions. When only the dome of the cup is assumed to be bonded to the bone, the stresses in the head increase dramatically and there is no more stress shielding. Five years after implantation radiographic signs of loosening of the femoral component were seen in 6.8% of the implants placed without notching in the femoral neck and in 28.6% of the components with notching (significant difference, P = 0.0005). Signs of loosening of the acetabular component were seen in 37.7% 5 years postoperatively. The cumulative survival rates of the femoral and acetabular components were 89.7% and 85.6% respectively 5 years after implantation. The overall clinical results are represented by an integration of the clinical results (Harris Hip Score System), the radiographic results and the survival analysis. This gave a success rate of only 72% 5 years after implantation.
de Waal Malefijt
M C
MC
University Hospital St. Radboud, Institute of Orthopaedics, Nijmegen, The Netherlands.
Huiskes
R
R
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D013314:Stress, Mechanical; D016896:Treatment Outcome