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DOS Kongressen 2017 ·
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EQUIVALENT FEMORAL STEM FIXATION WITH HI-FA-
TIGUE AND PALACOS BONE-CEMENTS. A 2 YEAR RAN-
DOMIZED CONTROLLED TRIAL WITH RADIOSTEREO-
METRIC ANALYSIS
Peter Bo Jørgensen, Martin Lamm, Kjeld Søballe, Maiken Stilling
Department of Orthopedic Surgery, Department of Clinical Medicine, Aarhus
University Hospital, Aarhus University
Background:
Long-term fixation of cemented femoral stems relies on several
factors including cement-adhesion and -fatigue. Hi-Fatigue Bone Cement (HF)
is a third-generation high viscosity bone cement that initially, during and after
mixing, has a lower viscosity compared to Palacos® Bone Cement (P). This al-
lows for low porosity, good mechanical strength, and a stable bone-cement in-
terface with optimal bone penetration. P shows excellent 10-year survival with
CPT-stem (98.7%) and is considered gold standard. Subsidence of cemented
femoral stems at 2-year follow-up has been shown to predictive of revision.
Purpose / Aim of Study:
The purpose of the study was to compare stem sub-
sidence after fixation with HF and P bone cements.
Materials and Methods:
The study design was a patient- blinded, randomized,
controlled study. Based on a sample size calculation, fifty-two patients with os-
teoarthrosis (age>70, t-score>-2.5) were block- randomized to HF (Zimmer)
or P (Haereus). Patients received CPT stems (12-14 conus Cr-Co) (Zimmer)
and 6-8 tantalum beads. Bone- cements were vacuum-mixed and the time for
cement phases systematically registered. Supine stereoradiographs were ob-
tained, and clinical outcomes were OHS and VAS pain. Follow-up was performed
at postop, 3 and 6 months, 1 and 2 years.
Findings / Results:
Mean subsidence was similar (p=0.68) for HF (1.12 mm
(SD 0.42)) and P (1.19 mm (SD 0.38)). There were no differences in total
translation (p=0.67) and total rotation (p=0.15). Mean OHS was 41.5 (SD 8.6)
and mean VAS pain was 1.1 (SD 2.2) (p>0.78). Cement working times were
similar, but the curing time was longer for H (13:43 min) than for P (11:35 min)
(p= 0.00).
Conclusions:
Fixation of the CPT femoral stem was equivalent with Hi-Fatigue
and Palacos bone cements up to 2 years follow-up. Based on the predictive
value of RSA we also expect equivalent long-term results.
No conflicts of interest reported
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