Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: II. Clinical proof of concept--40 patients followed for 2 years.
BACKGROUND
We have developed a bone-conserving commercially pure titanium hip replacement system using osseointegration principles: a metaphyseal loading proximal femoral component affixing into the retained neck and metaphysis only, leaving the femoral canal untouched. The acetabular cup closely fits a dual-geometry cavity, avoiding stress protection at the dome.


METHODS
After extensive laboratory and clinical pilot trial investigations, the surface-engineered implants were submitted to a prospective randomized controlled clinical trial involving 40 patients (40 hips), in which they were compared to the cemented Spectron femoral component and cementless Trilogy cup as control implant. The following clinical measures were used to monitor progress at regular intervals for the first 2 postoperative years: radiostereometric analysis (RSA), Harris Hip Score, pain score, WOMAC, and SF-36.


RESULTS
After 2 years of follow-up, no statistically significant differences were seen between the groups concerning rotation or translation along the cardinal axes. The patients receiving the Gothenburg osseointegrated titanium (GOT) system had significantly higher Harris Hip Score at 6 months, suggesting more rapid recovery. WOMAC, SF-36 and pain analysis were similar for the first 2 postoperative years.


CONCLUSIONS
Our RSA data suggest that osseointegration was achieved for all patients receiving the GOT hip system. This bone-conserving prosthesis may provide a good alternative, especially for young and active patients.
Carlsson
Lars V
LV
Department of Biomaterials Research, Institute of Surgical Sciences, University of Gothenburg, Sweden. lars.v.carlsson@vgregion.se
Albrektsson
Tomas
T
Albrektsson
Björn E J
BE
Jacobsson
C Magnus
CM
Macdonald
Warren
W
Regnér
Lars
L
Weidenhielm
Lars R
LR
D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D002484:Cementation; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D015207:Osteoarthritis, Hip / Q000601:surgery; D010780:Photogrammetry; D011474:Prosthesis Design; D011475:Prosthesis Failure; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium