Open AccessClinical Consequences of Stress Shielding After Porous-Coated Total Hip Arthroplasty
Author(s) -
Charles A. Engh,
Anthony Young,
Charles A. Engh,
Robert H. Hopper
Publication year - 2003
Publication title -
clinical orthopaedics and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.178
H-Index - 204
eISSN - 1528-1132
pISSN - 0009-921X
DOI - 10.1097/01.blo.0000096825.67494.e3
Subject(s) - stress shielding , medicine , electromagnetic shielding , osteolysis , total hip arthroplasty , stress (linguistics) , radiography , orthopedic surgery , arthroplasty , stress fractures , surgery , implant , composite material , materials science , linguistics , philosophy
From a series of 223 extensively porous-coated total hip arthroplasties, 208 hips had radiographic followup at a minimum of 2 years, which could be evaluated for radiographic evidence of stress-shielding. These patients had a mean 13.9-year followup (range, 2-18 years). We compared the outcome of 48 total hip arthroplasties that had radiographically evident stress-shielding with 160 total hip arthroplasties that did not have radiographically visible stress-shielding or that had less severe stress-shielding. Stress-shielding was more likely in females, patients with a low cortical index, and patients with larger stems. At the most recent followup, patients with stress-shielding had a lower mean walking score than patients without stress-shielding and less osteolysis. No patients with stress-shielding had femoral loosening, implant fractures, or loss of porous coating. The revision rate was 13% (six hips) among hips with stress-shielding and 21% (33 hips) among hips without stress-shielding. Fifteen-year survivorship was 93% among hips with stress-shielding and 77% among hips without stress-shielding. Stress-shielding did not produce adverse consequences in these extensively porous-coated total hip arthroplasties.