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For stable implantation of anatomically conforming femur prostheses, modifications that accommodate curving and torsion are necessary. In accordance to this concept, the anatomically shaped SBG stem has been developed. The first consecutive implantations were evaluated. 194 primary arthroplasties with uncemented anatomical, HA coated SBG stems were performed. Mean patient age was 61 years. 143 patients with 151 (78%) SBG stems were followed-up clinically and radiologically after an average of 10 (9-11) years. So far, only one implant had to be revised. Survivorship with revision of the femoral component is 99.5% at ten years. The mean postoperative Harris Hip Score was 92. Patients over 75 years had a score of 89; younger patients under 40 years scored 94. Sclerotic lines were seen in zone I or VII in 8%. Minor femoral remodeling (Type 1) occurred proximally in 75%. Minor thickening of the femur at the level of the tip of the prosthesis could be observed in 27% of the cases. There is no correlation between compacta thickening and clinical symptoms (p=0.15). The anatomical shape, the oval diameter and the longitudinal grooves secure stable primary fixation. Together with the HA coating, which enhances osseointegration, the SBG stem has a high success rate in the medium and long term. Um eine den anatomischen Verhältnissen entsprechende Femurprothese stabil einsetzen zu können, sind Modifikationen hinsichtlich Torquierung und Krümmung erforderlich. Zur Realisierung dieses Konzeptes wurde die anatomisch adaptierte SBG Prothese entwickelt. Von August 1990 bis Dezember 1991 wurden wurden 194 SBG Prothesen bei Erstoperationen implantiert. Das Patientenalter war durchschnittlich 61 Jahre. 143 Patienten mit 151 Hüfttotalendprothesen (78%) wurden klinisch und radiologisch nach durchschnittlich 10 (9-11) Jahren beurteilt. Bisher musste lediglich ein Implantat gewechselt werden. Die 10 Jahre Überlebensrate ist 99,5%. Postoperativ wurde ein Harris Hip Score-Wert von 92 erreicht, wobei die Patienten unter 40 Jahren einen Score-Wert von 94, Patienten über 75 Jahre von 89 haben. Skleroselinien zeigen sich proximal in Zone I oder VII (Typ 1) in 8%. Ein geringes Remodeling des Schaftes (Typ 1) ist proximal in 75% zu sehen. Eine minimale Kompaktaverbreiterung in Höhe der Prothesenspitze zeigt sich 27%. Zwischen den radiologischen Auffälligkeiten und der klinischien Symptomatik bestehen keine Korrelationen (p=0,15). Durch die anatomisch adaptierte Form, den ovalen Querschnitt sowie Längsrillen wird primär eine optimale Rotationsstabilität erreicht. Zusammen mit der Titanlegierung sowie der HA-Beschichtung werden damit ausgezeichnete Langzeitergebnisse erreicht.
Biomedizinische Technik / Biomedical Engineering – de Gruyter
Published: Oct 1, 2004
Keywords: SBG stem; hip arthroplasty; cementless; anatomic adapted shape; HA-coating
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