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Hip: Y.-H. Kim Long-term results of the cementless porous-coated anatomic total hip prosthesis J Bone Joint Surg Br 2005; 87-B: 623-627 [Abstract] [Full text] [PDF]

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Response to Mr Todkar

Young-Hoo Kim   (13 June 2005)

Complications of cementless stems

Manoj Todkar   (12 May 2005)

Response to Mr Todkar 13 June 2005
Young-Hoo Kim, Professor Ewha Womans University Send letter to journal: Re: Response to Mr Todkar younghookim{at}ewha.ac.kr Young-Hoo Kim	Sir, One of factors which contributed to early failure of the first-generation cementless femoral stem was poor filling of the femur.1 Good results of the cementless femoral stem were obtained when the femur was filled satisfactorily.2,3 In modern total hip arthroplasty, the predominant cause of failure of acetabular and femoral components are acetabular polyethylene liner wear and osteolysis. I believe that the reason for a higher survival rate of the cementless femoral stem compared with the acetabular component is that the bone quality of the femur is stronger than that of the acetabulum.4 Y-H KIM The Joint Replacement Centre of Korea, Seoul, Korea. 1. Kim Y-H, Oh J-H, Oh S-H. Cementless total hip arthroplasty in patients with osteonecrosis of the femoral head. Clin Orthop 1995;320:73-84. 2. Bojescul JA, Xenos JS, Callaghan JJ, Savory CJ. Results of porous-coated anatomic total hip arthroplasty without cement at fifteen years: a concise follow-up of a previous report. J Bone Joint Surg [Am] 2003;85-A:1079-83. 3. Kim Y-H, Kim VE. Uncemented porous-coated anatomic total hip replacement: results at six years in a consecutive series. J Bone Joint Surg [Br] 1993;75-B:6-13. 4. Chandler HP, Reineck FT, Wixson RL, McCarthy JC. Total hip replacement in patients younger than thirty years old: a five-year follow-up study. J Bone Joint Surg [Am] 1981;63-A:1426-34.
Complications of cementless stems 12 May 2005
Manoj Todkar, Orthopaedic Trainee Nuffield Orthopaedic Centre Send letter to journal: Re: Complications of cementless stems mtodkar{at}hotmail.com Manoj Todkar	Sir, I read this article with great interest. In the results section Mr Kim stated that 21% of acetabular and 10% of femoral components were revised for aseptic loosening or osteolysis. However, in our experience of uncemented total hip replacement (THR), the acetabular components require revison for aseptic loosening more often than do femoral stems. In a large number of papers it has been stated that in cementless THR femoral stems survive for only a short duration compared with acetabular components. Yet in practice we have seen that femoral stems survive better than acetabular components. Do you have an explanation for this? M. TODKAR Nuffield Orthopaedic Centre, Oxford, UK.