Evidence map›Paper›PMID 39191973›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Comparative analysis of femoral bone loss: uncemented vs. cemented aseptic stem loosening in first-time revision surgery-a retrospective evaluation of 215 patients.

Nele Wagener, Sebastian Hardt, Matthias Pumberger, Friederike Schömig

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Nele WagenerCenter for Musculoskeletal Surgery, Department of Orthopaedic Surgery, Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany. nele.wagener@charite.de.ORCID http://orcid.org/0000-0002-4012-1363
Sebastian HardtCenter for Musculoskeletal Surgery, Department of Orthopaedic Surgery, Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.ORCID http://orcid.org/0000-0001-8774-7585
Matthias PumbergerCenter for Musculoskeletal Surgery, Department of Orthopaedic Surgery, Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.ORCID http://orcid.org/0000-0002-0885-7370
Friederike SchömigCenter for Musculoskeletal Surgery, Department of Orthopaedic Surgery, Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.ORCID http://orcid.org/0000-0002-9224-7363

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe integrity of the femoral bone is crucial when considering reconstructive options for the first-time revision of a total hip arthroplasty (THA). Aseptic loosening of primary stems, whether cemented or uncemented, significantly affects the volume and quality of resultant femoral bone loss. This study evaluates the impact of the initial fixation method on femoral bone defect patterns by comparing the extent of bone loss. MATERIALS AND

methodsA retrospective cohort of 215 patients with either cemented or uncemented stems, indicated for aseptic stem loosening, and undergoing first-time stem revision from 2010 to 2022 at our institution was analyzed. Femoral bone loss extent at first-time revision was preoperatively gauged using radiographs and categorized by the Paprosky classification. Survival probabilities pre-first-time revision for both stem types were calculated using Kaplan-Meier methods. Hazard ratios were applied to compare the risk of initial revision for uncemented versus cemented stems within the first and subsequent 2nd to 10th years post-primary implantation.

resultsCemented stems were associated with a higher occurrence of significant bone defects of type 3a (23.53% vs. 14.02%, p = .108), 3b (39.22% vs. 1.22%, p < .001), and 4 (3.92% vs. 0.00%) compared to uncemented stems. Conversely, smaller defects of type 1 and 2 were more prevalent in uncemented stem loosening (84.76% vs. 33.33%, p < .001). Notably, cemented stems exhibited a significantly prolonged revision-free period over the complete decade following primary insertion (p < .001). The unadjusted risk of first-time revision due to stem loosening showed a tendency to an increase in uncemented stems within the initial postoperative year (HR 5.55, 95% CI 0.74; 41.67, p = .096), and an adjusted risk of 2.1 (95% CI 0.26; 16.53, p = .488). However, these differences did not reach statistical significance. In the subsequent 2nd-10th years, the risk was lower compared to cemented stems (HR 2.35, 95% CI 1.39; 3.99, p = .002).

conclusionsUncemented primary stems necessitating first-time revision due to aseptic loosening demonstrated notably smaller femoral bone defects in comparison to primary cemented stems.

Indexed as

Arthroplasty, Replacement, HipBone CementsFemurHip ProsthesisProsthesis FailureReoperationAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesBone CementsAseptic looseningFemoral bone defectsFirst-time revisionImplant survivalPaprosky classificationStem fixation (cemented/uncemented)

Identifiers

PMID39191973
PMCPMC11417084

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.