The goal of this study was to compare the migration of noncemented diffusion sintered titanium fi... more The goal of this study was to compare the migration of noncemented diffusion sintered titanium fibermesh-coated tibial components with (HA group) and without (non-HA group) additional hydroxyapatite coating. For this purpose digital radiostereometry (DIRSA) was used to compare the migration after 2 and 9 years for the two groups. After 2 years the mean maximum subsidence of the HA-coated components (0.24+/-0.18 mm) was about one-half of the mean maximum subsidence of the non-HA-coated group (0.55+/-0.55 mm). After 9 years the maximum subsidence of the HA-coated components was still smaller, but not as pronounced as before. The same trend was also found for the endpoint maximum total point motion (MTPM). After 2 years the mean MTPM of the HA-coated components was 0.66+/-0.38 mm and of the non-HA group 0.73+/-0.50 mm. After 9 years the mean MTPM for the HA-coated components was 0.54+/-0.15 mm and for the non-HA-coated components 0.74+/-0.20 mm. None of the HA-coated tibial components ...
Heterotopic ossification (HO) after total hip arthroplasty is known to be a major complication wi... more Heterotopic ossification (HO) after total hip arthroplasty is known to be a major complication with an impact on the functional outcome. Efforts have been made to prevent the occurrence of HO by means of either radiation therapy or pharmacotherapy. To date, there are no data available regarding the relative benefit of radiation versus medication with non-steroidal anti-inflammatory drugs. The objective of this study was to compare single-dose 600-cGy radiation therapy with indomethacin medication for their effect on the prevention of heterotopic bone formation after total hip arthroplasty. In all, 154 patients were included in the study. All patients underwent primary total hip arthroplasty due to osteoarthritis. Patients were randomly assigned to three different therapeutic groups. (a) The radiation group received a single radiation dose of 600 cGy between the 2nd and 4th postoperative day. (b) The indomethacin group received an oral application of indomethacin 2 x 50 mg per day from the 1st to 42nd postoperative day. (c) The control group received neither radiation nor indomethacin medication. There were significant group differences (P < 0.001). A least significant difference test (LSD) revealed that the mean of the control group was significantly different from that of the radiation and indomethacin groups. The 13 patients (8.4%) classified Brooker 3 or 4 were all in the control group. Again, this effect was statistically significant (chi-square, P < 0.001). In conclusion, this study demonstrated that both radiation and indomethacin therapy are effective in the prevention of postoperative HO. The choice for either one of the treatments has to be based on availability, contraindications, side-effects, practicability, standardisation and cost. Based on these considerations together with the results of this study, we currently use postoperative radiation with 600 cGy for all patients undergoing primary total hip arthroplasty.
The goal of this study was to compare the migration of noncemented diffusion sintered titanium fi... more The goal of this study was to compare the migration of noncemented diffusion sintered titanium fibermesh-coated tibial components with (HA group) and without (non-HA group) additional hydroxyapatite coating. For this purpose digital radiostereometry (DIRSA) was used to compare the migration after 2 and 9 years for the two groups. After 2 years the mean maximum subsidence of the HA-coated components (0.24+/-0.18 mm) was about one-half of the mean maximum subsidence of the non-HA-coated group (0.55+/-0.55 mm). After 9 years the maximum subsidence of the HA-coated components was still smaller, but not as pronounced as before. The same trend was also found for the endpoint maximum total point motion (MTPM). After 2 years the mean MTPM of the HA-coated components was 0.66+/-0.38 mm and of the non-HA group 0.73+/-0.50 mm. After 9 years the mean MTPM for the HA-coated components was 0.54+/-0.15 mm and for the non-HA-coated components 0.74+/-0.20 mm. None of the HA-coated tibial components ...
Heterotopic ossification (HO) after total hip arthroplasty is known to be a major complication wi... more Heterotopic ossification (HO) after total hip arthroplasty is known to be a major complication with an impact on the functional outcome. Efforts have been made to prevent the occurrence of HO by means of either radiation therapy or pharmacotherapy. To date, there are no data available regarding the relative benefit of radiation versus medication with non-steroidal anti-inflammatory drugs. The objective of this study was to compare single-dose 600-cGy radiation therapy with indomethacin medication for their effect on the prevention of heterotopic bone formation after total hip arthroplasty. In all, 154 patients were included in the study. All patients underwent primary total hip arthroplasty due to osteoarthritis. Patients were randomly assigned to three different therapeutic groups. (a) The radiation group received a single radiation dose of 600 cGy between the 2nd and 4th postoperative day. (b) The indomethacin group received an oral application of indomethacin 2 x 50 mg per day from the 1st to 42nd postoperative day. (c) The control group received neither radiation nor indomethacin medication. There were significant group differences (P < 0.001). A least significant difference test (LSD) revealed that the mean of the control group was significantly different from that of the radiation and indomethacin groups. The 13 patients (8.4%) classified Brooker 3 or 4 were all in the control group. Again, this effect was statistically significant (chi-square, P < 0.001). In conclusion, this study demonstrated that both radiation and indomethacin therapy are effective in the prevention of postoperative HO. The choice for either one of the treatments has to be based on availability, contraindications, side-effects, practicability, standardisation and cost. Based on these considerations together with the results of this study, we currently use postoperative radiation with 600 cGy for all patients undergoing primary total hip arthroplasty.
Uploads