Midterm Results of Total Hip Arthroplasty Using the VerSys Fiber Metal Tapered Femoral Stem / 대한고관절학회지

PURPOSE: We evaluated the clinical and radiological results of patients who received the cementless VerSys fiber metal tapered stem for total hip arthroplasty. MATERIALS AND METHODS: Thirty seven hip joint replacements(31 patients) were evaluated over a minimum four year period following the procedure with an average follow-up period of 56 months(48-96 months). The mean patient age was 47.9 years old. Clinical results were analyzed using Harris hip scores, incidence of thigh pain and radiographic analysis was used to assess fixation of the stem, stress shielding, cortical hypertrophy and radiolucent lines around the femoral stem. RESULTS: The average Harris hip score was 90.7 points(82-99 points). Thigh pain was noticed in 6 hips(16%). Proximal femoral bone resorption by stress shielding was observed in 32 hips(86.5%). Cortical hypertrophy was noticed in 16 hips(43.2%) and was statistically correlated with stress shielding of 2nd degree or more according to the Engh classification. Stable bone ingrowth at the last follow-up was seen in 36 hips(97.2%). CONCLUSION: Cementless total hip arthroplasty using the cementless VerSys fiber metal tapered stem demonstrated excellent midterm clinical results as well as excellent radiologic results for stable fixation and endosteal new bone formtion. However, long term follow-up evaluation will be required because of the high rates of proximal bone resorption by stress shielding.

Cementless Total Hip Arthroplasty Using VerSys Fiber Metal Midcoat Stem: a Minimum 3-Years Follow-up

PURPOSE: The purpose of this study was to retrospectively evaluate the results of cementless total hip arthroplasties that used a Versys fiber metal midcoat femoral stem. MATERIALS AND METHODS: From March 2000 to June 2005, 28 cases in 23 patients were followed up for a minimum of three years. The average follow up period was 5.1 years. Clinical results were evaluated by Harris hip scores. Radiographic analysis was done by evaluating fixation stability, osteolysis, stress shielding, and cortical hypertrophy. RESULTS: The mean Harris hip score improved from 43.1 to 93.8 at the last follow up. In radiographic analyses of the stem, there was no evidence of positional changes or vertical subsidence. There was heterotopic ossification in four, distal cortical hypertrophy in two, proximal stress shielding in twenty, and femoral osteolysis in five cases. The femoral stem revealed a stable bony ingrowth in all. The acetabular cup revealed a stable bony ingrowth in all. There was no evidence of horizontal or vertical migration or of a change of inclination angle of the acetabular cup. CONCLUSION: Cementless total hip arthroplasty using a Versys fiber metal midcoat femoral stem showed good clinical and radiologic results, but long term follow up is needed.

Primary Total Hip Arthroplasty with Cementless VerSys Femoral Stem: a Minimum 5-years follow-up

PURPOSE: This study evaluated the clinical and radiographic results of primary total hip arthroplasty with a noncemented VerSys Fiber Metal Midcoat stem. MATERIALS AND METHODS: Thirty nine hips in thirty three patients were followed up for a minimum of five years. The clinical results were evaluated based on the Harris hip scores. Radiographic analysis of the femoral component was performed by evaluating the radiolucent lines, cortical hypertrophy, stress shielding, osteolysis and fixation stability. Radiographic analysis of the acetabular component was performed by evaluating the osteolysis and fixation stability. RESULTS: The average Harris hip score improved from 54.3 points preoperatively to 95.4 points at the last followup. In the results of radiographic analysis of the femoral component, stable bony ingrowth was noted in thirty-eight cases and stable fibrous ingrowth was observed in one. Non-progressive radiolucency<2 mm in width was observed in eight cases. There were three cases of osteolysis, thirty-six cases of stress shielding, and one case of cortical hypertrophy. Radiographic analysis of the acetabular component revealed stable bony ingrowth in thirty-eight cases and unstable fixation in one case. There were two cases of osteolysis. CONCLUSION: The results of primary total hip arthroplasty using cementless VerSys femoral stem after a minimum of five-year follow up revealed that the rate of femoral osteolysis had decreased and the rate of bone resorption by stress shielding was relatively high. However, a longer-term follow up will be needed.