Guest guest Posted January 20, 2004 Report Share Posted January 20, 2004 > Maybe I missed something somewhere..... Also thanks for the > ion discussion - lots of helpful info there. S-ROM is a brand name of total-hip-replacement stem made by Depuy. I could be mistaken, but I thought it was originally designed for use in hip revisions. Today it is used for both primary and revision THR. Its very modular (which can be good and bad) -- good: it allows swapping of femoral necks and the sleeve that fits on the proximal femur, which can allow for corrections in unusual defects of bone alignment and shape without making a custom stem. bad: more parts, means more joints between parts, means more possible points of fretting or failure. Two concerns I would have I am aware of no device that has any reliable expectation to last 40- 50 years -- not that it couldn't happen, but I don't think that should be the expectation at this point. DePuy does not offer large diameter metal-metal heads. Preserving the natural size of the joint is an advantage for resurfacing or the large head THR. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2004 Report Share Posted January 20, 2004 I was told that most THRs do not wear out that fast, but that generally the prosthesis becomes loose inside the femur shaft, both in cases when the shaft is filled with grounded bone material and/or when cement is applied. Do you think I might have misunderstood this? Dan ) +44 (0)7974 981-407 ( +44 (0)20 8501-2573 @ dan.milosevic@... Re: What is an SROM THR? > Maybe I missed something somewhere..... Also thanks for the > ion discussion - lots of helpful info there. S-ROM is a brand name of total-hip-replacement stem made by Depuy. I could be mistaken, but I thought it was originally designed for use in hip revisions. Today it is used for both primary and revision THR. Its very modular (which can be good and bad) -- good: it allows swapping of femoral necks and the sleeve that fits on the proximal femur, which can allow for corrections in unusual defects of bone alignment and shape without making a custom stem. bad: more parts, means more joints between parts, means more possible points of fretting or failure. Two concerns I would have I am aware of no device that has any reliable expectation to last 40- 50 years -- not that it couldn't happen, but I don't think that should be the expectation at this point. DePuy does not offer large diameter metal-metal heads. Preserving the natural size of the joint is an advantage for resurfacing or the large head THR. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2004 Report Share Posted January 20, 2004 Dan/ This Excerpt is from The Swedish Hip Registry. This is used as statistical data for THR's almost universally - i.e AAOS - The English language version is usually a couple of years out of date but non-the-less better statistics than word of mouth from certain OS's etc. http://www.jru.orthop.gu.se/archive/AAOS-2000-NHR.pdf reference page 6 Survival of all primary total hip replacement procedures separated in cemented, uncemented and hybrid fixation techniques are illustrated. The first period covers 1979- 1987 and the second 1988-1998. The cut off between these two time periods is consistent with the general change to a modern cementing technique in Sweden. It is therefore relevant to speak of an early versus a modern surgical cementing technique during these two time periods. The third time period, 1992-1998, was chosen as modern uncemented technology was introduced around 1992. The cemented implants have improved substantially over time. The uncemented implants also display some improvement during the three time intervals. Using modern cementing technique, a 94,6% 10-year survival is obtained for hip replacement with index diagnosis osteoarthrosis and revised due to aseptic loosening. Including all other causes for revision would decrease the survival rate by 1-2%. The uncemented technology had a disappointing result in the cohort operated prior to 1988. In the last period modern cup designs and active surface coating on the femoral component were used. Results have improved and cementless fixation still have worse results but are used in younger patients. The continuous quality improvement is well illustrated in the figures below. There has been a reduction, for cemented implants, in revision for mechanical failure from 9% (the 1979 cohort) to 3% (the 1988 cohort) after ten years. A major improvement is seen for revision due to deep infection and the cumulative revision rate for deep infection after 10 years is approximately 0.3%. ! © 2000 The Swedish National Hip Arthroplasty Registry. . Re: What is an SROM THR? > Maybe I missed something somewhere..... Also thanks for the > ion discussion - lots of helpful info there. S-ROM is a brand name of total-hip-replacement stem made by Depuy. I could be mistaken, but I thought it was originally designed for use in hip revisions. Today it is used for both primary and revision THR. Its very modular (which can be good and bad) -- good: it allows swapping of femoral necks and the sleeve that fits on the proximal femur, which can allow for corrections in unusual defects of bone alignment and shape without making a custom stem. bad: more parts, means more joints between parts, means more possible points of fretting or failure. Two concerns I would have I am aware of no device that has any reliable expectation to last 40- 50 years -- not that it couldn't happen, but I don't think that should be the expectation at this point. DePuy does not offer large diameter metal-metal heads. Preserving the natural size of the joint is an advantage for resurfacing or the large head THR. Quote Link to comment Share on other sites More sharing options...
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