José M Pelayo-de-Tomás1, José L Rodrigo-Pérez1, Carlos D Novoa-Parra2, Alejandro Lizaur-Utrilla3, María Morales-Suárez-Varela4,5, José Antonio Blas-Dobón1. 1. Department of Orthopaedic Surgery, Doctor Peset University Hospital, Av Gaspar Aguilar, 90, 46017, Valencia, Spain. 2. Department of Orthopaedic Surgery, Doctor Peset University Hospital, Av Gaspar Aguilar, 90, 46017, Valencia, Spain. le_male2002@hotmail.com. 3. Faculty of Medicine, Miguel Hernandez University, Elche, Spain. 4. Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Valencia, Spain. 5. CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Abstract
PURPOSE: The objective was to assess aseptic complications and functional outcome using a primary total hip arthroplasty with modular neck. METHODS: Prospective cohort of 317 consecutive patients. The mean age was 61.1 (range, 41-84) years. The H-Max-M model (Lima, Italy) system was used in all patients. The functional assessment was made by the Harris Hip Score, Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Radiological outcomes were also assessed, and adverse events and complications were noted. RESULTS: The mean follow-up was 6.1 (range, 2-8) years. Functional outcome significantly improved in most patients. There were 3 deep infections (0.9%) and 17 aseptic complications (5.3%) including 1 intraoperative acetabular fracture, 3 later periprosthetic femoral fractures, 1 broken ceramic insert, 1 acetabular loosening, 3 femoral loosening and 1 broken titanium modular neck in a obese patient. No pseudotumors or elevated serum levels of metal ions were found among the patients with radiolucent lines or aseptic loosening. CONCLUSIONS: The findings in the present study showed that the H-MAX-M stem provided satisfactory functional outcome in most patients with a low rate of complications attributable to the modular neck design. We consider that using this novel modular neck-stem coupling design can be an alternative to the conventional monoblock stems in patients without overweight.
PURPOSE: The objective was to assess aseptic complications and functional outcome using a primary total hip arthroplasty with modular neck. METHODS: Prospective cohort of 317 consecutive patients. The mean age was 61.1 (range, 41-84) years. The H-Max-M model (Lima, Italy) system was used in all patients. The functional assessment was made by the Harris Hip Score, Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Radiological outcomes were also assessed, and adverse events and complications were noted. RESULTS: The mean follow-up was 6.1 (range, 2-8) years. Functional outcome significantly improved in most patients. There were 3 deep infections (0.9%) and 17 aseptic complications (5.3%) including 1 intraoperative acetabular fracture, 3 later periprosthetic femoral fractures, 1 broken ceramic insert, 1 acetabular loosening, 3 femoral loosening and 1 broken titanium modular neck in a obesepatient. No pseudotumors or elevated serum levels of metal ions were found among the patients with radiolucent lines or aseptic loosening. CONCLUSIONS: The findings in the present study showed that the H-MAX-M stem provided satisfactory functional outcome in most patients with a low rate of complications attributable to the modular neck design. We consider that using this novel modular neck-stem coupling design can be an alternative to the conventional monoblock stems in patients without overweight.
Entities:
Keywords:
Functional outcome; H-MAX M hip system; Modular neck; Pseudotumor; Serum metal ion level; Total hip arthroplasty
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