[Long-term influence of the spongiosa metal surface prosthesis on the periprosthetic bone. A radiological and osteodensitometric analysis of implantation of the S& G (ESKA) hip prosthesis].
BACKGROUND
The anatomically shaped, cementless total hip replacement (THR) (S and G, ESKA Lübeck) has a fully porous coating for secondary osseointegration. The aim of the present study was to analyse the long-term effect of the prosthesis on periprosthetic bone remodelling.


METHODS
137 THR in 117 patients were analysed clinically and radiographically 12.8 years (10-14.9 years) postoperatively. The average age at the last follow-up was 71.8 years (range: 34-87 years). Osteodensitometric DEXA measurements of the periprosthetic bone in comparison to the contralateral non-operated femora were performed.


RESULTS
Cumulative survival rates of all implanted THR (n = 231) at 14.9 years were 86.2 % (+/-5.3 %) for the fully porous coated stem and 90.1 % (+/- 8 %) for the cup. Five stem fractures (3.6 %) at the middle part were recorded. The Harris hip score of the non-revised THR at the last follow-up averaged 88.3 (34-100) points. Bony atrophy in the proximal periprosthetic femora in Gruen zones I (16.8 %) and VII (34.6 %) confirmed a proximal stress-shielding. Osteodensitometric analyses demonstrated in comparison to the contralateral femora (BMD 1.3 g/cm (2)) a significantly reduced bone density at the calcar femoris (BMD 0.9 g/cm (2)) (p < 0.001).


CONCLUSIONS
The original goal of a physiological load transfer has not been realised with this fully porous, cementless THR. The anatomic S & G stem will mainly be osseointegrated by distal load transfer.
Götze
C
C
Klinik und Poliklinik für Allgemeine Orthopädie des Universitätsklinikum Münster. chrgoetze@uni-muenster.de
Tschugunow
A
A
Wiegelmann
F
F
Osada
N
N
Götze
H G
HG
Böttner
F
F
D015502:Absorptiometry, Photon / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008670:Metals; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D013499:Surface Properties; D016896:Treatment Outcome
D008670:Metals