Ten to Twelve-Year Results With the Zweymüller Cementless Total Hip Prosthesis

doi:10.1016/j.arth.2004.11.017

The Journal of Arthroplasty

Volume 20, Issue 3, April 2005, Pages 362-368

https://doi.org/10.1016/j.arth.2004.11.017 Get rights and content

Abstract

Between January 1987 and December 1990, 221 Zweymüller cementless total hip arthroplasties were performed in 211 patients with idiopathic osteoarthritis. A total of 136 patients (142 prostheses) were evaluated at a mean follow-up of 134 months (SD 9.5). The study group consisted of 78 Hochgezogen and 64 Stepless stem prostheses, all with a threaded titanium cup and ceramic head. No clinical and radiological differences were found between the 2 stem prostheses. Seven cups had been revised because of aseptic loosening; 17 cups showed radiolucent lines, osteolysis, or migration. Mean linear polyethylene wear of 105 (74%) cups was 0.46 mm (SD 0.27), with an annual wear of 0.04 mm (SD 0.02). Wear did not correlate with pain, cup migration, radiolucent lines, or osteolysis. Cumulative survival was 96%. Zweymüller cementless total hip arthroplasty showed good midterm results.

Section snippets

Prosthesis

The self-cutting truncated conical cup (Sulzer, Switzerland) was made of pure titanium (Ti-6Al-7Nb) with a microstructure of 3 to 5 μm (Fig. 1). The flat bottom was furnished with 2 openings, and the lining had a titanium cover to prevent bone-polyethylene contact. An ultrahigh-density polyethylene insert (Chirulen, Germany) of at least 5.5-mm thickness was placed into the 1.5-mm-thick metal wall. All the cups were used in combination with a 32-mm alumina ceramic head (Biolox, Germany) [5].

Two

Results

The study group comprised 41 men and 95 women, with 66 unilateral left-sided prostheses, 64 unilateral right-sided prostheses, and 6 bilateral prostheses. Average age was 61 years (SD 8.1) at the time of surgery, 68 years (SD 8.0) in phase I, and 72 years (SD 7.9) in phase II. Mean follow-up was 86 months (SD 9.1) in phase I and 134 months (SD 9.5) in phase II.

Mean Harris hip scores in phases I and II were 91 (SD 10.5) and 90 (SD 12.8), respectively. In phase II, 26 (18%) hips were classified

Discussion

The aim of our study was to assess the midterm results with the Zweymüller cementless hip system, especially the threaded cup. Laboratory studies have shown favorable results with threaded cups, but success rates with cementless threaded cup devices vary [17]. Engh et al [18] reported disappointing short-term results with the cementless threaded Mecron cup (Mecron, Berlin, Germany) and the comparable Anderson cup (Mecron). These threaded cups had an open metal dome that left the polyethylene

Acknowledgments

The authors thank the orthopedic surgeons at the 5 Dutch hospitals for participating in the study: G.J.T.M. Boog (Rijnstate Hospital Arnhem), W.H.J.C. van Heeswijk (Amphia Hospital Oosterhout), W.A. den Boer (Diaconessenhuis Eindhoven), H.A.G.M. Sala (St Joseph Hospital Veldhoven), and J. Vegter (Elkerliek Hospital Helmond).

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Both longer human life expectancy and implantation in younger patients point to the need for orthopaedic implants with a prolonged lifetime (Long and Rack, 1998). New cementless fixation (i.e. a technique which implants the endoprosthesis directly into the bone without cement fixation) contributes to the lifetime of the prosthesis (Vervest et al., 2005). A direct bone–implant interface allows enhanced osteointegration, which prevents loosening of the implant (Buechel et al., 2004).
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: Benefits or funds were received in partial or total support of the research materials described in this article. These benefits and/or support were received from research fund “Stichting Wetenschappelijk Onderzoek Rijnstate,” the Netherlands. The funding source was a grant from the Sulzer Orthopedie, the Netherlands.

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Original ArticleTen to Twelve-Year Results With the Zweymüller Cementless Total Hip Prosthesis

Abstract

Section snippets

Prosthesis

Results

Discussion

Acknowledgments

J. Arthroplasty

J. Arthroplasty

Which primary total hip replacement?

J. Bone Joint Surg. Br.

Survival analysis of cementless grit-blasted titanium total hip arthroplasties

J. Bone Joint Surg. Br.

Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup: a minimum ten-year follow-up

J. Bone Joint Surg. Am.

Total hip arthroplasty with use of the cementless Zweymüller Alloclassic system: a ten to thirteen-year follow-up study

J. Bone Joint Surg. Am.

Survivorship of rough-surfaced threaded acetabular cups: 382 consecutive primary Zweymüller cups followed for 0.2-12 years

Acta Orthop. Scand.

Morphometric examination of straight, tapered titanium stems: A retrieval study

Clin. Orthop.

The long-term results of low-friction arthroplasty of the hip performed as a primary intervention

J. Bone Joint Surg. Br.

Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluations

J. Bone Joint Surg. Am.

Treatment of primary osteoarthritis of the hip: a comparison of total joint and surface replacement arthroplasty

J. Bone Joint Surg. Am.

Clinical and radiographic evaluation of total hip replacement: a standard system of terminology for reporting results

J. Bone Joint Surg. Am.

Radiological demarcation of cemented sockets in total hip replacement

Clin. Orthop.

The porous-coated anatomic total hip prosthesis, inserted without cement: results after five to seven years in a prospective study

J. Bone Joint Surg. Am.

“Mode of failure” of cemented stem-type femoral components: a radiographic analysis of loosening

Clin. Orthop.

Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components

Clin. Orthop.

The Madreporic cementless total hip arthroplasty: new experimental data and a seven-year clinical follow-up study

Clin. Orthop.

Original Article
Ten to Twelve-Year Results With the Zweymüller Cementless Total Hip Prosthesis