Article

Despite the fact that there have been some reports on
poor performance, titanium femoral stems intended for cemented fixation are still
used at some centers in Europe. In this population-based registry study, we
examined the results of the most frequently used cemented titanium stem in
Norway. METHODS: 11,876 cases implanted with the cemented Titan stem
were identified for the period 1987-2008. Hybrid arthroplasties were excluded,
leaving 10,108 cases for this study. Stem survival and the influence of age, sex,
stem offset and size, and femoral head size were evaluated using Cox regression
analyses. Questionnaires were sent to the hospitals to determine the surgical
technique used. RESULTS: Male sex, high stem offset, and small stem size were
found to be risk factors for stem revision, (adjusted RR = 2.5 (1.9-3.4), 3.3
(2.3-4.8), and 2.2 (1.4-3.5), respectively). Patients operated in the period
2001-2008 had an adjusted relative risk (RR) of 4.7 (95% CI: 3.0-7.4) for stem
revision due to aseptic stem loosening compared to the period 1996-2000. Changes
in broaching technique and cementing technique coincided with deterioration of
the results in some hospitals. INTERPRETATION: The increased use of small stem
sizes and high-offset stems could only explain the deterioration of results to a
certain degree since the year 2000. The influence of discrete changes in surgical
technique over time could not be fully evaluated in this registry study. We
suggest that this cemented titanium stem should be abandoned. The results of
similar implants should be carefully evaluated.
- Norvège

Langue : ANGLAIS