ARTHROPLASTY
A randomized study on migration of the Spectron EF and the Charnley flanged 40 cemented femoral components using radiostereometric analysis at 2 years
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):31 Acta Orthop. 2011 Oct;82(5):538-44. Epub 2011 Sep 6150 patients with primary or secondary osteoarthritis of the hip were randomized to undergo THA with either a Charnley or Spectron EF femoral stem. The 2 year results indicate that the Spectron EF stem has superior stability when compared to the Charnley stem, which demonstrated significantly more stem retroversion and posterior translation. Future studies are required to determine if similar results are found over longer follow-up periods.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Oui = 1
Incertain = 0,5
Non pertinent = 0
Non = 0
L'évaluation des critères de rapport permet d'évaluer la transparence avec laquelle les auteurs rapportent les caractéristiques méthodologiques et les caractéristiques de l'essai dans la publication. L'évaluation est divisée en cinq catégories qui sont présentées ci-dessous.
3/4
Randomization
2/4
Outcome Measurements
2/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'indice de fragilité est un outil qui aide à l'interprétation des résultats significatifs, en fournissant une mesure de la force d'un résultat. L'indice de fragilité représente le nombre d'événements consécutifs qui doivent être ajoutés à un résultat dichotomique pour que le résultat ne soit plus significatif. Un petit nombre représente un résultat plus faible et un grand nombre un résultat plus fort.
Pourquoi cette étude était-elle nécessaire maintenant ?
There are many possible mechanisms that can cause femoral stem loosening in cemented total hip replacements including the material, design, and surface finish. Debonding between the cement and femoral stem initiates this loosening, and to address this issue there are many different femoral stem designs aimed at increasing fixation and preventing loosening. The Spectron femoral stem is increasingly being used and has resulted in successful outcomes; however, there is a lack of comparisons to other femoral stems.
Quelle était la principale question de recherche ?
What effect does the use of a Charnley or Spectron EF femoral stem have on migration in patients with hip osteoarthritis undergoing cemented total hip replacement, measured over 2 year follow-up period?
Quels sont les résultats importants ?
- At 2 years, stem retroversion (mean internal rotation) was 2.3 and 0.7 degrees (p<0.001), and posterior translation (negative translation along z-axis) was 0.44mm and 0.17mm (p=0.002) for the patients in the Charnley group and Spectron EF groups respectively.
- At 2 years, subsidence (migration along y-axis) was 0.26mm for Charnley group, compared to 0.20mm for Spectron EF group (p=0.5).
De quoi dois-je me souvenir en priorité ?
Results from the two year follow-up found that the Charnley stem had more significantly more stem retroversion and posterior translation, compared to the Spectron EF stem.
Comment cela affectera-t-il les soins prodigués à mes patients ?
Although the Spectron EF stem proved to be more stable throughout the 2 year duration of this study, these good short-term results do not necessarily translate into successful long-term outcomes. Therefore, studies with longer-term follow up periods, which evaluate the impact of design, materials and surface finish of the implant on loosening and resulting migration, are required.
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