title: 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.
abstract: 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.
authors.affiliation: Department of Biomaterials Research, Institute of Surgical Sciences, University of Gothenburg, Sweden. lars.v.carlsson@vgregion.se
authors.forename: Lars V
authors.initials: LV
authors.lastname: Carlsson
authors.forename: Tomas
authors.initials: T
authors.lastname: Albrektsson
authors.forename: Björn E J
authors.initials: BE
authors.lastname: Albrektsson
authors.forename: C Magnus
authors.initials: CM
authors.lastname: Jacobsson
authors.forename: Warren
authors.initials: W
authors.lastname: Macdonald
authors.forename: Lars
authors.initials: L
authors.lastname: Regnér
authors.forename: Lars R
authors.initials: LR
authors.lastname: Weidenhielm
mesh_terms: 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
chemical_list: D014025:Titanium