scholarly journals Clinical and Radiographic Evaluation of a Commercially Pure Cancellous-Structured Titanium Press Fit Total Hip Prosthetic Stem: Ten-Year Followup of the “Natural Hip” Femoral Stem

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Thomas B. Pace ◽  
James C. Karegeannes ◽  
M. Jason Palmer ◽  
Stephanie L. Tanner ◽  
Rebecca G. Snider
Keyword(s):  
Hip Arthroplasty ◽  
Groin Pain ◽  
Stress Shielding ◽  
Femoral Stem ◽  
Thigh Pain ◽  
Radiographic Evaluation ◽  
Total Hip ◽  
Press Fit ◽  
Age Range ◽  
Hip Arthroplasties

This study evaluates the outcomes of 92 hip arthroplasties using a press fit, tapered, split tip, proximally porous ingrowth (CSTi) femoral stem (Zimmer Natural Hip) in consecutive hip arthroplasty patients followed for an average of ten years postoperatively (range 5–16 years). Patients were functionally and radiographically evaluated using Harris Hip Scores and plain radiographs assessing postarthroplasty groin or thigh pain and radiographic signs of stem subsidence, proximal femoral fixation, stress shielding, and related calcar resorption. At followup of 5–10 years, the incidence of groin pain and thigh pain was 9.1% and 3.6%, respectively. This incidence improved over time. Beyond 10 years of followup, groin pain was 2.7% and thigh pain zero. In 89% of cases, there was solid contact between the calcar and the undersurface of the stem collar. Five cases were revised for instability (5.4%). The Harris Hip Scores and the incidence of thigh or groin pain were very favorable compared to other reported press fit total hip arthroplasty stems and not significantly different across a broad age range. There were no cases of stem loosening of failure of bony ingrowth into the stem.

scholarly journals Distal Femoral Cortical Hypertrophy after Hip Arthroplasty Using a Cementless Double-Tapered Femoral Stem

2016 ◽  
Vol 24 (3) ◽  
pp. 317-322 ◽  
Author(s):  
Yoon Je Cho ◽  
Young Soo Chun ◽  
Kee Hyung Rhyu ◽  
Jong Hun Baek ◽  
Hu Liang
Keyword(s):  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
Stress Shielding ◽  
Femoral Stem ◽  
Visual Analogue Score ◽  
Thigh Pain ◽  
Harris Hip Score ◽  
Cortical Hypertrophy ◽  
Flare Index ◽  
The Mean

Purpose To review 437 hips in 404 patients who underwent total hip arthroplasty (THA) or hemiarthroplasty using the Accolade TMZF stem to determine the incidence and risk factors of distal femoral cortical hypertrophy (DFCH). Methods Records of 437 hips in 169 men and 235 women aged 26 to 100 (mean, 65.7) years who underwent THA (n=293) or hemiarthroplasty (n=144) using the Accolade TMZF femoral stem by 2 senior surgeons and were followed up for a mean of 54.7 months were reviewed. Clinical outcome was assessed using the modified Harris Hip Score and visual analogue score for pain. Proximal femoral geometry and canal flare index were assessed on preoperative radiographs, and DFCH, stem position, subsidence, loosening, and stress shielding were assessed on postoperative radiographs according to the Gruen zone. Results Of 437 hips, 27 (6.2%) developed DFCH and 410 did not. Hips with DFCH had a higher incidence of thigh pain (18.5% vs. 2.2%, p<0.001) and earlier onset of thigh pain (12.3 vs. 20.8 months, p=0.015), compared with those without. Nonetheless, all femoral stems were well-fixed, and no osteolysis or loosening was detected. The 2 groups achieved comparable clinical outcome in terms of Harris Hip Score and pain. The mean canal flare index was higher in hips with than without DFCH (3.706 vs. 3.294, p=0.002). The mean vertical subsidence of the femoral stem was lower in hips with than without DFCH (1.5 vs. 3.4 mm p<0.001). Subsidence negatively correlated with the canal flare index (correlation coefficient= −0.110, p=0.022). The incidence of the DFCH increased with each unit of increment in canal flare index (odds ratio [OR]=1.828, p=0.043) and each year younger in age (OR=0.968, p=0.015). Conclusion The incidence of DFCH in hips with the Accolade TMZF stem was 6.2%. Patients with a higher canal flare index and younger age had a higher incidence of DFCH. Nonetheless, DFCH did not affect clinical outcome or femoral stem stability.

scholarly journals Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty

2016 ◽  
Vol 35 (8) ◽  
pp. 1774-1783 ◽  
Author(s):  
Sajad Arabnejad ◽  
Burnett Johnston ◽  
Michael Tanzer ◽  
Damiano Pasini
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Stress Shielding ◽  
Femoral Stem ◽  
Total Hip ◽  
3D Printed

Definition and validation of a system for classifying the undersized Corail femoral stem in total hip arthroplasty

2021 ◽  
pp. 112070002199600
Author(s):  
Jamie S McConnell ◽  
Farhan A Syed ◽  
Paul Saunders ◽  
Raviprasad Kattimani ◽  
Anthony Ugwuoke ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Classification System ◽  
Femoral Stem ◽  
Observer Agreement ◽  
Stem Size ◽  
Total Hip ◽  
Initial Fixation ◽  
Uncemented Total Hip Arthroplasty ◽  
Hip Arthroplasties

Introduction: The uncemented total hip arthroplasty relies on a secure initial fixation of the femoral stem to achieve osseointegration. Undersizing of the femoral implant compromises this. Surgeons routinely review postoperative radiographs to assess appropriate sizing, but existing methods of assessment lack standardisation. We present a system of accurately and reliably classifying radiological undersizing, which will help us better understand the factors that might have led to undersizing. Aim: To describe and evaluate a classification system for assessing radiological undersizing of the uncemented stem in hip arthroplasty. Method: We conducted a retrospective review of 1,337 consecutive hip arthroplasties using the Corail stem. Two independent investigators reviewed post-operative radiographs and classified them as either appropriately sized or undersized. Undersized stems were sub-categorised into four subtypes: uniformly undersized, varus undersized, valgus undersized or ‘cocktail-glass’ undersized. Inter- and intra-observer agreement was determined. The accuracy of our classification system was validated by comparison with digital re-templating. We further assessed patient demographics and stem size in relation to sizing. Results: 1 in 5 cases (19.75%) were deemed radiologically undersized. The commonest subtypes of undersizing were uniformly (47%) and varus (39%) undersized. When assessing sizing and subtype categorisation, inter-observer agreement was 89–92% and intra-observer agreement 86%. Classification decisions showed 92% and 97% accuracy for uniformly undersizing and varus undersizing respectively when validated against digital re-templating. Age, gender and smaller stem size were significantly associated with radiological undersizing. The Corail KLA model (125° neck) was found to have a higher incidence of stems undersized in varus. Conclusions: This study describes and validates a classification system for the analysis of radiological undersizing.

Leg Length Discrepancy in Total Hip Arthroplasty with the use of Cemented and Uncemented Femoral Stems. A Prospective Radiological Study

2009 ◽  
Vol 19 (3) ◽  
pp. 264-267 ◽  
Author(s):  
Riaz Ahmad ◽  
Vinod Sharma ◽  
Harvey Sandhu ◽  
Michael Bishay
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Radiological Study ◽  
Total Hip ◽  
Length Discrepancy ◽  
Femoral Stems ◽  
Hip Arthroplasties

Leg length discrepancy may occur following total hip arthroplasty, with a potentially impaired functional outcome as a result. The aim of this study was to compare the leg length discrepancy between both cemented and uncemented femoral stems when used in total hip arthroplasty. A prospective radiological study of 200 consecutive primary total hip arthroplasties was performed between June 2005 and December 2006. Pre and post-operative radiographs were analysed. 56 (56%) of the total hip arthroplasties where an uncemented femoral stem was used had a leg length discrepancy over 1 cm. However only 23 (23%) of the total hip arthroplasties with a cemented femoral stem had a leg length discrepancy over 1 cm. The use of cemented femoral stems in total hip arthroplasty results in a lower incidence of leg length discrepancy, with a potentially better functional outcome.

scholarly journals Comparison of Total Hip Arthroplasty Outcomes after Failed Femoral Wedge or Curved Varus Osteotomy

2018 ◽  
Vol 12 (1) ◽  
pp. 208-217
Author(s):  
Motoki Sonohata ◽  
Masaru Kitajima ◽  
Shunsuke Kawano ◽  
Masaaki Mawatari
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Average Duration ◽  
Corrective Osteotomy ◽  
Japanese Orthopaedic Association ◽  
Radiographic Evaluation ◽  
Varus Osteotomy ◽  
Total Hip ◽  
Hip Arthroplasties

Background: Differences in clinical and radiographic results following total hip arthroplasty between failed wedge and curved varus osteotomy are unclear. Objective: To investigate differences in clinical and radiographic results following total hip arthroplasty in patients who exhibited failed wedge or curved varus osteotomy. Method: We performed 18 total hip arthroplasties after failed femoral varus osteotomy. Hips were divided into two groups: 14 had failed wedge varus osteotomy and four had failed curved varus osteotomy. Average ages at osteotomy and total hip arthroplasty were 27 years old (range, 10-46 years old) and 56 years old (range, 25-74 years old), respectively. The average duration of follow-up monitoring was 72.2 months (range, 54-91 months). Clinical and radiographic evaluations were completed for each group. Results: The Japanese Orthopaedic Association hip score of total hip arthroplasty after failed varus osteotomy significantly improved at the last follow-up in both groups. However, hip score at the last follow-up was significantly higher after failed curved varus osteotomy than after failed wedge varus osteotomy (p<0.01). Four hips that failed wedge varus osteotomy underwent subtrochanteric corrective osteotomy with total hip arthroplasty. Radiographic evaluation showed that three stems for total hip arthroplasty after failed wedge varus osteotomy were inserted in malposition, and all stems in total hip arthroplasty after failed curved varus osteotomy were inserted in the normal position. Conclusion: Surgeons performing femoral varus osteotomy should consider possible future conversion to total hip arthroplasty. Curved varus osteotomy is more suitable than wedge varus osteotomy for future conversion to total hip arthroplasty.

scholarly journals RADIOGRAPHIC EVALUATION OF EARLY OUTCOME AFTER TWO TYPES OF CEMENTLESS HIP ARTHROPLASTY

2019 ◽  
Vol 36 ◽  
pp. 41-49
Author(s):  
Jędrzej Roman Tschurl ◽  
Maciej Kasprzyk ◽  
Patryk Kasongo ◽  
Tomasz Jopek
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Position Angle ◽  
Radiographic Evaluation ◽  
Good Reliability ◽  
Total Hip ◽  
Medical Histories ◽  
Stem Position

Introduction Total Hip Arthroplasty is one of the most common orthopaedic procedures. Its outcome is assessed by radiographic evaluation. Two principal radiographic parameters are cup inclination and stem position angle. Aim The study aimed to compare radiological outcomes of two total hip arthroplasty techniques: Alloclassic Zweymüller versus Corail Pinnacle endoprostheses. Material and methods Medical histories of 345 patients who had a hip replacement between 2007 and 2017 were reviewed. Patients with primary total hip arthroplasty with both of mentioned systems were included in the research. Seven observers individually evaluated the radiological images of the 67 endoprostheses (39 Alloclassic Zweymüller and 26 Corail Pinnacle). The cup inclination and the stem position angle were measured using MB-Ruler programme. Results There was no statistical difference (p > 0.338) in cup inclination angle between Alloclassic Zweymüller and Pinnacle cups, with the angle ranging from 31.01° to 58.80° (45.20° on average) and from 30.61° to 59.1° (43.60° on average), respectively. Femoral stem position did not differ between both types of endoprosthesis (p > 0.932), ranging from −1.05° to 7.87° (3.09° on average) for Alloclassic Zweymüller and 0.35° to 7.79° (3.06° on average) for Corail Pinnacle stem. ICC (Intraclass Coefficient Correlation) was estimated and their 95% confident intervals were calculated for cup inclination and stem position showing good reliability of cup inclination measurements. Conclusions Both types of endoprostheses presented similar radiological outcomes. Cup inclination can be used by non-experienced medical staff to reliably assess the postoperative radiograms. Keywords: cementless hip replacement, radiological outcomes, imaging.

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