title: Implication of femoral stem on performance of articular surface replacement (ASR) XL total hip arthroplasty.
abstract: Taper junctions of large diameter metal-on-metal femoral heads and femoral stems were described as metal ion generator due to accelerated wear and corrosion. However, literature about the Articular Surface Replacement (ASR) total hip arthroplasty (THA) invariably deals with stems manufactured by DePuy Orthopedics (Warsaw, IN, USA). Nothing is known whether different stems with common 12/14 mm tapers affect failure rate or ion release. 99 ASR THA (88 patients) implanted with CoxaFit or ARGE Geradschaft stems (K-Implant, Hannover, Germany) were retrospectively analyzed. After a mean follow-up of 3.5 years revision rate was 24.5%, mostly due to adverse reaction to metal debris (ARMD). CT scan revealed component loosening in 10.3% and pseudotumoral lesions in 12.6%. Elevated ion concentrations (>7 μg/l) were found in 38.6%.
authors.affiliation: Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Cip
authors.affiliation: Moos 4, Wangen, Germany.
authors.forename: Archibald
authors.initials: A
authors.lastname: von Strempel
authors.affiliation: Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Bach
authors.affiliation: Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Luegmair
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Benesch
authors.affiliation: Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria.
authors.forename: Arno
authors.initials: A
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D003343:Corrosion; D005260:Female; D005269:Femur / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D061825:Metal-on-Metal Joint Prostheses / Q000009:adverse effects*; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies
keywords: ASR; Articular Surface Replacement; failure rate; femoral stem; total hip arthroplasty; total hip replacement