Published for the British Editorial Society of Bone & Joint Surgery by Churchill Livingstone
Journal of Bone and Joint Surgery. British Volume vol:Proceedings 91-B pages:443-c
Annual Meeting of the European Orthopaedic Research Society edition:17 location:Madrid date:24-26 April 2008
Radiostereometric analysis (RSA) is a technique that can be used to measure in-vivo micro-motion of the components of hip arthroplasty.
86 patients received a titanium custom-made prosthesis. The average age was 64 year (20y –84y). During the study 30 patients out of 86 received a cementless femoral stem. The choice of stem fixation is determined by the quality of the bone. In all cases a 36 mm cobalt chromium head is used. Spherical tantalum markers, chosen because of the proven biocompatibility, were inserted into stable locations in the femoral bone during surgery using a specialized insertion tool, according to the protocol. Evaluation was done 1, 6, 12, 24, 52 weeks after surgery.
Overall subsidence follows a parallel pattern for the cemented and uncemented prosthesis that is slightly stronger in for the uncemented prosthesis. Over the 6 months evaluation period the prosthesis migrates towards the lateral side with 0.25 mm in both groups. An anteroversion of 0.5° to 1° is noted at 6 months follow-up. The varus valgus movement of the prosthesis is similar for both groups at 6 months. At 6 weeks a slight valgus flexion is noted, this is reversed at 3 months. At this point in time the effect is more pronounced in the group with a cemented prosthesis.
Micro motion is difficult to assess on plain radiography. In this study more subsidence is noted in the uncemented prosthesis compared to the cemented. The degree of rotation of the stem measured in our study is comparable with those reported by others. In our primary THR we observe a bi-modal micromotion except for the subsidence the initial movement up till 6 weeks is reversed at 3 months follow-up and at 6 months the prosthesis seems stabilized, though longer follow-up is required to confirm stabilization.