High rates of implant fracture of a generic polished tapered femoral stem
OBJECTIVES: Cemented polished tapered stems have demonstrated excellent long-term outcomes. Based on this concept, many generic tapered stems have been released into the market. The aim of this study was to evaluate implant-related complications of 1 specific stem design.
METHODS: Between 2010 and 2017, 315 total hip replacements were performed using a Fortress stem (Biotechni, La Ciotat, France). Patient records and radiology were retrospectively reviewed for implant-related complications. A failure analysis was performed on the failed Fortress stems in order to determine the cause of premature failure.
RESULTS: 7 (2.2%) patients sustained a fracture of the neck of the implant after a mean of 5 years (range 50-81 months). All fractures were atraumatic, originating at the introducer inlet of the stem. All fractured occurred in obese patients (BMI >33 kg/m2) with a small sized prosthesis. Of these, there were 5 135° and 2 125° stems. Fracture risk was 23% (7/30) for patients with a small sized stem and a BMI >30 kg/m2. All cases were revised using a cement-in-cement technique or a cementless modular revision stem. Failure analysis on the retrieved stems revealed a stress riser at the bottom of the introducer inlet.
CONCLUSIONS: An alarmingly high rate of early implant fractures was seen using this specific type of cemented stem, particularly when using smaller implant sizes in obese patients. Although based on a proven design, a specific modification led to a stress riser in the neck area, which resulted in a high incidence of implant failure. This series underlines the importance of a stepwise introduction into the market of new orthopaedic devices even when based on established concepts. Generic stems may not behave as the original stem upon which it was designed.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Hip international : the journal of clinical and experimental research on hip pathology and therapy - 32(2022), 1 vom: 15. Jan., Seite 99-105 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Vanbiervliet, Jens [VerfasserIn] |
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| Links: |
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| Themen: |
Cemented stem |
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| Anmerkungen: |
Date Completed 13.01.2022 Date Revised 30.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/1120700020925739 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM310414776 |
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| 245 | 1 | 0 | |a High rates of implant fracture of a generic polished tapered femoral stem |
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| 500 | |a Date Completed 13.01.2022 | ||
| 500 | |a Date Revised 30.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: Cemented polished tapered stems have demonstrated excellent long-term outcomes. Based on this concept, many generic tapered stems have been released into the market. The aim of this study was to evaluate implant-related complications of 1 specific stem design | ||
| 520 | |a METHODS: Between 2010 and 2017, 315 total hip replacements were performed using a Fortress stem (Biotechni, La Ciotat, France). Patient records and radiology were retrospectively reviewed for implant-related complications. A failure analysis was performed on the failed Fortress stems in order to determine the cause of premature failure | ||
| 520 | |a RESULTS: 7 (2.2%) patients sustained a fracture of the neck of the implant after a mean of 5 years (range 50-81 months). All fractures were atraumatic, originating at the introducer inlet of the stem. All fractured occurred in obese patients (BMI >33 kg/m2) with a small sized prosthesis. Of these, there were 5 135° and 2 125° stems. Fracture risk was 23% (7/30) for patients with a small sized stem and a BMI >30 kg/m2. All cases were revised using a cement-in-cement technique or a cementless modular revision stem. Failure analysis on the retrieved stems revealed a stress riser at the bottom of the introducer inlet | ||
| 520 | |a CONCLUSIONS: An alarmingly high rate of early implant fractures was seen using this specific type of cemented stem, particularly when using smaller implant sizes in obese patients. Although based on a proven design, a specific modification led to a stress riser in the neck area, which resulted in a high incidence of implant failure. This series underlines the importance of a stepwise introduction into the market of new orthopaedic devices even when based on established concepts. Generic stems may not behave as the original stem upon which it was designed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cemented stem | |
| 650 | 4 | |a generic | |
| 650 | 4 | |a hip arthroplasty | |
| 650 | 4 | |a implant fracture | |
| 650 | 4 | |a revision | |
| 650 | 4 | |a stem design | |
| 700 | 1 | |a Braem, Annabel |e verfasserin |4 aut | |
| 700 | 1 | |a Simon, Jean-Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Van Humbeek, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Brouwers, Jonas |e verfasserin |4 aut | |
| 700 | 1 | |a Ghijselings, Stijn |e verfasserin |4 aut | |
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