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SECONDARY STABILIZATION OF TITANIUM PROTHESES IN ELDERLY PATIENTS



Abstract

Aim: To investigate the potential of biological fixation of cementless total hip arthroplasty (THA) in patients over 75 years old, with diagnosed osteoporosis.

Material-Methods: Between 1994–2000, 30 patients (mean age 77.3 years) underwent cementless THA.25 patients were found at the last follow-up, which ranged from 3–7 years (mean follow-up,4 years).THA was performed due to primary osteoarthritis (n=18), subcapital fracture (n=5), or dysplastic hip (n=2).7 Spotorno,9 Synergy and 9 Perfecta prostheses were implanted.Singh index was used for the evaluation of osteoporosis and Harris Hip Score (HHS) was used for the clinical evaluation of each patient.Modified Wixon score was used for the evaluation of stability probability of the tapered stem.Engh score was calculated for the evaluation of osseointegration of the porous coated implants.

Results: Pre and post-operative mean Singh index was grade 4.Mean HHS at the last follow-up was 88.6.For the Spotorno stem a stable fixation probability was calculated at 74.8%.Porous coated stems provided +13.45 mean Engh score,implying satisfactory fixation of the implant.Postoperative systematic complications are not reported.

Conclusions: In patients over 75 years old, with possible cardiopulmonary disease, cementless total hip arthroplasty offers a reliable treatment,regardless the presence of osteoporosis.Satisfactory osseointegration and absence of systematic complications is compromised by the high cost of titanium implants.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.