Hip Pelvis.  2018 Dec;30(4):210-218. 10.5371/hp.2018.30.4.210.

Hip Arthroplasty Using the Bencox® Hip System: An Evaluation of a Consecutive Series of One Thousand Cases

• Lee JM
• Sim YS
• Choi DS

• KMID: 2427924
• DOI: http://doi.org/10.5371/hp.2018.30.4.210

Abstract

PURPOSE
This is a report on the outcomes associated with a consecutive series of 1,000 cementless hip arthroplasties utilizing the Bencox® hip stem-the first Korean-developed hip prosthesis.
MATERIALS AND METHODS
A consecutive series of 1,000 hip arthroplasties using the Bencox® hip stem were analyzed, starting from its initial release (September 2006) until June 2014. Patients in this consecutive series underwent surgery for fractures (n=552), arthritis (n=155), avascular necrosis (n=209), and revisions (n=84). Of these 1,000 cases, patients with a minimum follow-up of at least 1 year (n=616) were retrospectively analyzed for radiographic and clinical outcomes (i.e., Harris hip score). The stability of the prosthesis was evaluated by examining subsidence.
RESULTS
During the follow-up period (mean follow-up period of 54.8 months), there were 2 cases requiring revision of the femoral stem-both were caused by periprosthetic fractures and neither involved stem loosening. The mean Harris hip score during follow-up was 95.5. Bone ongrowth occurred in 95% of patients; no cases of subsidence or aseptic loosening of the stem were detected, and no cases of postoperative complications such as ceramic breakage were observed.
CONCLUSION
Clinical and radiographic evaluations of hip arthroplasty using the Bencox® hip stem revealed excellent outcomes with an average of 54.8 month follow-up in a consecutive series of 1,000 cases.

Keyword

Bencox® hip system; Cementless hip arthroplasty

MeSH Terms

Arthritis
Arthroplasty*
Ceramics
Follow-Up Studies
Hip Prosthesis
Hip*
Humans
Necrosis
Periprosthetic Fractures
Postoperative Complications
Prostheses and Implants
Retrospective Studies

Figure

• 

  Fig. 1 Bencox® (Corentec, Seoul, Korea) cementless femoral stem design, straight, rectangular, double wedged, tapered, titanium-alloy stem with a rough, grit-blasted surface. Note the smaller neck diameter (A), three vertical ribs in the stem shoulder area (B) and anatomical contour medial-proximal portion (C).

• 

  Fig. 2 (A) Radiograph of a 74-year-old female with right intertrochanter fracture. (B) Postoperative anteroposterior (AP) hip radiograph. (C) Six years after periprosthetic fracture (Vancouver type B2) AP hip radiograph. (D) Cemented stem bipolar hemiarthroplasty.

• 

  Fig. 3 (A) Radiograph of a 72-year-old female with left femoral neck fracture. (B) Postoperative anteroposterior (AP) hip radiograph. (C, D) Seven years after follow up hip AP and lateral radiograph reveals stable bony fixation without no subsidence or osteolysis.

• 

  Fig. 4 (A, B) Radiograph of a 47-year-old male with both osteonecrosis of femoral head. (C, D) Serially bilateral total hip arthroplasty post-operative anteroposterior (AP) hip radiograph. (E, F) Four years after follow up hip AP and lateral radiograph reveals stable joint.

• 

  Fig. 5 (A) A specially designed trapezoidal shape implant to increase range of motion. (B) Photographs revealing excellent prosthetic range of motions when simulated with smaller neck and 36-mm alumina head. In the sagittal plane, flexion and extension can be increased to 135° and 76°, respectively.

Reference

1. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007; 370:1508–1519. PMID: 17964352.

2. Banaszkiewicz PA. Radiological demarcation of cemented sockets in total hip replacement. In : Banaszkiewicz PA, Kader D, editors. Classic Papers in Orthopaedics. London: Springer;2014. p. 39–41.

3. Rothman RH, Cohn JC. Cemented versus cementless total hip arthroplasty. A critical review. Clin Orthop Relat Res. 1990; (254):153–169.

4. Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg Am. 2007; 89:1832–1842. PMID: 17671025.

5. Kim S, Lee JM, Kim WH, Han JK, Lee JY, Choi BI. Focal peliosis hepatis as a mimicker of hepatic tumors: radiological-pathological correlation. J Comput Assist Tomogr. 2007; 31:79–85. PMID: 17259837.

6. Kim JT, Yoo JJ. Implant design in cementless hip arthroplasty. Hip Pelvis. 2016; 28:65–75. PMID: 27536647.

7. Lim Y, Chang YJ, Kwon SY, Kim YS. A simple method using a PACS to minimize leg length discrepancy in primary THA: a method to minimize leg length discrepancy. J Arthroplasty. 2013; 28:1791–1795. PMID: 23540533.

8. Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. J Arthroplasty. 2002; 17(4 Suppl 1):17–22. PMID: 12068397.

9. Masonis JL, Bourne RB. Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop Relat Res. 2002; (405):46–53. PMID: 12461355.

10. Lee JM, Cho Y, Kim J, Kim DW. Wiring techniques for the fixation of trochanteric fragments during bipolar hemiarthroplasty for femoral intertrochanteric fracture: Clinical study and technical note. Hip Pelvis. 2017; 29:44–53. PMID: 28316962.

11. Banaszkiewicz PA. Ectopic ossification following total hip replacement: incidence and a method of classification. In : Banaszkiewicz PA, Kader D, editors. Classic Papers in Orthopaedics. London: Springer;2014. p. 105–107.

12. Chan KC, Gill GS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res. 2000; (371):206–215.

13. von Roth P, Abdel MP, Harmsen WS, Berry DJ. Cemented bipolar hemiarthroplasty provides definitive treatment for femoral neck fractures at 20 years and beyond. Clin Orthop Relat Res. 2015; 473:3595–3599. PMID: 26186915.

14. Hong CC, Nashi N, Makandura MC, Krishna L. Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link? Singapore Med J. 2016; 57:69–72. PMID: 26892829.

15. Stauffer RN. Ten-year follow-up study of total hip replacement. J Bone Joint Surg Am. 1982; 64:983–990. PMID: 7118986.

16. Sutherland CJ, Wilde AH, Borden LS, Marks KE. A ten-year follow-up of one hundred consecutive Müller curved-stem total hip-replacement arthroplasties. J Bone Joint Surg Am. 1982; 64:970–982. PMID: 7118985.

17. Bourne RB, Rorabeck CH, Ghazal ME, Lee MH. Pain in the thigh following total hip replacement with a porous-coated anatomic prosthesis for osteoarthrosis. A five-year follow-up study. J Bone Joint Surg Am. 1994; 76:1464–1470. PMID: 7929493.

18. Lavernia C, D'Apuzzo M, Hernandez V, Lee D. Thigh pain in primary total hip arthroplasty: the effects of elastic moduli. J Arthroplasty. 2004; 19(7 Suppl 2):10–16. PMID: 15457412.

19. Lee JM, Jeon JB. Result of a minimum five-year follow-up of hip arthroplasty using the Bencox® hip stem. J Korean Orthop Assoc. 2014; 49:126–132.

20. Cruz-Pardos A, García-Rey E, García-Cimbrelo E. Total hip arthroplasty with use of the cementless Zweymüller Alloclassic System: A concise follow-up, at a minimum of 25 years, of a previous report. J Bone Joint Surg Am. 2017; 99:1927–1931. PMID: 29135666.

21. Lee JM, Park YS. Long-term follow-up results after hip arthroplasty using a Cementless Spotorno (CLS) femoral stem. J Korean Orthop Assoc. 2008; 43:710–717.

22. Müller LA, Wenger N, Schramm M, Hohmann D, Forst R, Carl HD. Seventeen-year survival of the cementless CLS Spotorno stem. Arch Orthop Trauma Surg. 2010; 130:269–275. PMID: 19760225.

23. Haentjens P, Casteleyn PP, De Boeck H, Handelberg F, Opdecam P. Treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Primary bipolar arthroplasty compared with internal fixation. J Bone Joint Surg Am. 1989; 71:1214–1225. PMID: 2777850.

24. Barrack RL, Butler RA. Current status of trochanteric reattachment in complex total hip arthroplasty. Clin Orthop Relat Res. 2005; 441:237–242. PMID: 16331009.

25. Koyama K, Higuchi F, Kubo M, Okawa T, Inoue A. Reattachment of the greater trochanter using the Dall-Miles cable grip system in revision hip arthroplasty. J Orthop Sci. 2001; 6:22–27. PMID: 11289581.

26. Lim SJ, Lee KJ, Min BW, Song JH, So SY, Park YS. High incidence of stem loosening in association with periprosthetic femur fractures in previously well-fixed cementless grit-blasted tapered-wedge stems. Int Orthop. 2015; 39:1689–1693. PMID: 25385003.