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Year: 2010 Volume: 468 Issue: 1

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Proximally versus fully porous-coated femoral stems: a multicenter randomized trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	MacDonald, Steven J. Rosenzweig, Seth Guerin, Jeffrey S. McCalden, Richard W. Bohm, Eric R. Bourne, Robert B. Rorabeck, Cecil H. Barrack, Robert L.
Spatial Coverage	Canada Louisiana
Description	Country affiliation: Canada Author Affiliation: MacDonald SJ ( London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, ON, N6A 5A5, Canada. steven.macdonald@lhsc.on.ca)
Abstract	UNLABELLED: There are two broad-based categories of cementless femoral component designs: proximally porous-coated and fully porous-coated. While both have been widely used, there remains debate regarding differences in clinical outcome scores, relative incidence of thigh pain, and development of stress shielding. We investigated these variables in a multicenter prospective randomized blinded clinical trial of 388 patients from three centers: 198 patients had a proximally porous-coated tapered cementless femoral component and 190 patients had a fully porous-coated cementless femoral component. A minimum followup of 2 years (mean, 6.7 years; range, 2.0-8.65 years) was available in 367 of the 388 patients (95%). We observed no differences in age at surgery, body mass index, or preoperative clinical outcome scores (WOMAC, SF-12, Harris hip score, UCLA activity, thigh pain) with the two groups. We determined serial bone density changes in a subcohort of 72 patients from two of the three centers. The postoperative clinical outcome scores were similar at all followup intervals, and we observed no differences in the incidence of thigh pain at any time. Bone density reduction in Gruen Zone 7 was greater with the fully coated stem than the proximally coated stem (24% versus 15% reduction, respectively). Both fully and proximally coated stems performed well, with no clinical differences at 2 years' followup, except in bone mineral density evaluations. LEVEL OF EVIDENCE: Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
File Format	HTM / HTML
ISSN	0009921X
e-ISSN	15281132
DOI	10.1007/s11999-009-1092-3
Journal	Clinical Orthopaedics and Related Researchtextregistered
Issue Number	2
Volume Number	468
Language	English
Publisher	Springer
Publisher Date	2010-02-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopaedics Arthroplasty, Replacement, Hip Instrumentation Coated Materials, Biocompatible Femur Surgery Hip Joint Hip Prosthesis Absorptiometry, Photon Adverse Effects Bone Density Canada Double-blind Method Physiopathology Louisiana Pain Etiology Prevention & Control Pain Measurement Porosity Prospective Studies Prosthesis Design Prosthesis Failure Recovery Of Function Stress, Mechanical Surface Properties Time Factors Comparative Study Multicenter Study Randomized Controlled Trial
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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