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Solou K, Solou AV, Tatani I, Lakoumentas J, Tserpes K, Megas P. Increased stability of short femoral stem through customized distribution of coefficient of friction in porous coating. Sci Rep 2024; 14:12243. [PMID: 38806607 PMCID: PMC11133419 DOI: 10.1038/s41598-024-63077-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/24/2024] [Indexed: 05/30/2024] Open
Abstract
Stress shielding and aseptic loosening are complications of short stem total hip arthroplasty, which may lead to hardware failure. Stems with increased porosity toward the distal end were discovered to be effective in reducing stress shielding, however, there is a lack of research on optimized porous distribution in stem's coating. This study aimed to optimize the distribution of the coefficient of friction of a metaphyseal femoral stem, aiming for reducing stress shielding in the proximal area. A finite element analysis model of an implanted, titanium alloy short-tapered wedge stem featuring a porous coating made of titanium was designed to simulate a static structural analysis of the femoral stem's behavior under axial loading in Analysis System Mechanical Software. For computational feasibility, 500 combinations of coefficients of friction were randomly sampled. Increased strains in proximal femur were found in 8.4% of the models, which had decreased coefficients of friction in middle medial areas of porous coating and increased in lateral proximal and lateral and medial distal areas. This study reported the importance of the interface between bone and middle medial and distal lateral areas of the porous coating in influencing the biomechanical behavior of the proximal femur, and potentially reducing stress shielding.
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Affiliation(s)
- Konstantina Solou
- Department of Orthopaedic Surgery and Traumatology, School of Medicine, University of Patras, Patras, Greece.
| | - Anna Vasiliki Solou
- Department of Mechanical Engineering & Aeronautics, University of Patras, Patras, Greece
| | - Irini Tatani
- Department of Orthopaedic Surgery and Traumatology, School of Medicine, University of Patras, Patras, Greece
| | - John Lakoumentas
- Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece
| | - Konstantinos Tserpes
- Department of Mechanical Engineering & Aeronautics, University of Patras, Patras, Greece
| | - Panagiotis Megas
- Department of Orthopaedic Surgery and Traumatology, School of Medicine, University of Patras, Patras, Greece
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Richardson VR, Chong ACM, Brown AN. Biomechanical Comparison of Impaction Techniques and Cross-Sectional Femoral Stem Shapes for Cementless Total Hip Arthroplasty. Kans J Med 2024; 17:30-33. [PMID: 38694181 PMCID: PMC11060782 DOI: 10.17161/kjm.vol17.21522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/26/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Traditional mallet broaching and stem seating in cementless total hip arthroplasty (THA) can result in femoral stem misalignment, potentially reducing implant longevity. This study aimed to compare the pullout strength of cementless THA femoral stems with different cross-sectional designs achieved through the powered impactor method versus the traditional mallet method. Methods The authors utilized 24 polyurethane foam femurs and two femoral bone preservation stems with different proximal cross-sectional shapes (double taper: ACTIS®, size 5; flat taper: TRI-LOCK®, size 5). A single orthopedic surgeon broached each femur from size 0 to size 5 using either the powered impactor or mallet impaction methods. Broaching time and component implantation times were recorded. A load-to-failure pullout strength test was conducted, and the ultimate pullout load was recorded. Results The broaching time for the TRI-LOCK® stem showed a statistically significant difference between the two impaction methods (powered: 37±7 seconds, mallet: 75±29 seconds, F[3, 20] = 4.56, p = 0.002), but no statistically significant difference was detected for the ACTIS® stem between the two impaction methods (powered: 47±22 seconds, mallet: 59±9 seconds, F[3, 20] = 4.56, p = 0.304). There was a statistically significant difference in pullout strength between the two impaction groups, and this strength was influenced by the implant cross-sectional shape (ACTIS®: 774±75N versus 679±22N, F(3,20) = 16.38, p = 0.018; TRI-LOCK®: 616±57N versus 859±85N, F(3, 20) = 16.38, p <0.001). Conclusions The technique used for femoral bone preparation (powered impactor versus mallet) and the cross-sectional design of the cementless femoral stem are crucial factors that affect initial stem stability and operation time.
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Affiliation(s)
- Vanessa R Richardson
- Department of Sanford Medical Education, Sanford Health, Fargo, ND
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND
| | - Alexander C M Chong
- Department of Sanford Medical Education, Sanford Health, Fargo, ND
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND
| | - Anthony N Brown
- Department of Sanford Medical Education, Sanford Health, Fargo, ND
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND
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LaCour M, Nguyen TD, Nachtrab J, Bonnin M, Komistek R. Alignment and mechanics evaluation for a compaction broach stem versus a blade style proximal press fit stem using 3-Dimensional planning. J Biomech 2024; 163:111950. [PMID: 38237494 DOI: 10.1016/j.jbiomech.2024.111950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/06/2023] [Accepted: 01/10/2024] [Indexed: 02/10/2024]
Abstract
Three-dimensional (3D) preoperative planning tools can be used to help plan and compare component alignment scenarios for different total hip arthroplasty systems to ultimately improve postoperative outcomes and patient satisfaction. The objective of this study is to use 3D preoperative planning tools based on patient-specific bone models to compare two different stem designs, specifically a compaction broach stem and a proximal press fit stem. The planner uses patient-specific proximal femoral bone morphology to suggest a specific implant size and placement. The planner then allows for preoperative predictions of component head positioning, stem fit within the canal, and potential cortical bone reaming that must be done, as well as postoperative predictions of stability and mechanics. The stems were evaluated to determine the accuracy of stem placement, the theoretical volumetric bone removal/reaming required to achieve a desired fit, and the associated postoperative mechanics. This study demonstrated that there was a difference in component alignment and predicted postoperative mechanics between a compaction broach stem and a press fit stem, with the compaction broach stem allowing for more accurate alignment with less required bone removal, resulting in improved postoperative stability and mechanics. This study also demonstrated that much of the stem misalignment for both systems occurred in the anterior/posterior direction. Overall, 3D preoperative planning offers significant benefits and novel intraoperative insight, and the industry should continue to enhance their THA preoperative planning tools.
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Lin B, Lan Y, Lu Z, Xie S, Lin F, Weng Y, Feng E, Chen J. The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty. BMC Musculoskelet Disord 2023; 24:319. [PMID: 37087443 PMCID: PMC10122324 DOI: 10.1186/s12891-023-06409-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/07/2023] [Indexed: 04/24/2023] Open
Abstract
OBJECTIVE To investigate whether the application of a curved rasp on the femoral side is effective in reducing the incidence of stem malalignment in total hip replacement with direct anterior approach (DAA-THA), followed by the analysis of the independent risk factors affecting stem malalignment. METHODS Retrospective analysis was carried out covering 160 patients undergoing DAA-THA from January 2019 to December 2021, with Tri-Lock (BPS, Depuy) stem applied in all 113 patients were screened according to inclusion and exclusion criteria. The data of gender, age, body mass index, preoperative diagnoses, Dorr classification, FAR ratio, pelvic morphology ratio, WOMAC scores, were analyzed to explore the independent factors influencing the malalignment of the femoral prosthesis implantation. Then data of patients were divided into group A and group B according to whether the curved rasp was taken during the operation. The chi-square test was performed to compare the incidence of femoral stem malalignment between the two groups. RESULTS There revealed two independent risk factors: BMI and FAR ratio that affected femoral stem malalignment. The increased BMI was associated with a higher probability of femoral stem malalignment (P<0.05), the probability of malalignment of femoral stem in FAR ratio<1 was 1.15 times higher than that in FAR>1(OR = 1.15, 95% CI: 1.03-1.28, P<0.05). Further grouping analysis showed that the incidence of femoral stem malalignment in patients with intraoperative application of curved rasp was 27%, while in patients without curved rasp, the incidence of femoral stem malalignment increased significantly to 48.7%(P<0.05). The placement angle of prosthesis in group A was significantly better than that in group B, especially mild femoral stem malalignment (0%) and severe femoral stem malalignment (2.70%), and the difference was statistically significant (P < 0.05). There found no significant difference in age, gander, intraoperative complications and last follow-up assessment of WOMAC scores between the two groups of patients. CONCLUSIONS In DAA-THA, BMI and FAR ratio act as the independent risk factors for femoral stem malalignment. Intraoperative use of a curved rasp significantly reduces the incidence of malalignment of the femoral stem.
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Affiliation(s)
- Bei Lin
- Department of Arthrosis Surgery, Fuzhou Second Hospital, Fuzhou, China
- The Department of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Yiping Lan
- Department of Arthrosis Surgery, Fuzhou Second Hospital, Fuzhou, China
| | - Zhiming Lu
- Department of Arthrosis Surgery, Fuzhou Second Hospital, Fuzhou, China
- The Department of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Shiwei Xie
- Department of Arthrosis Surgery, Fuzhou Second Hospital, Fuzhou, China
- The Department of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Feitai Lin
- Department of Arthrosis Surgery, Fuzhou Second Hospital, Fuzhou, China
| | - Yan Weng
- Department of Arthrosis Surgery, Fuzhou Second Hospital, Fuzhou, China
| | - Eryou Feng
- Department of Arthrosis Surgery, Fuzhou Second Hospital, Fuzhou, China.
- The Department of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China.
| | - Jinhua Chen
- Follow-Up Center, Fujian Medical University Union Hospital, Fuzhou, China
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Chu K, Wang Y, Yang M, Wei C, Huo J, Yao M, Li Z, Li H. Tri-Lock Bone Preservation Stem Versus Conventional Corail Stem in Primary Total Hip Arthroplasty via Direct Anterior Approach: A Short-Term, Retrospective, Comparative Study. Med Sci Monit 2023; 29:e939635. [PMID: 37062914 PMCID: PMC10120384 DOI: 10.12659/msm.939635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/16/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND he present study was performed to evaluate the clinical efficacy of Tri-Lock bone preservation stems vs conventional Corail stems in primary total hip arthroplasty via direct anterior approach. MATERIAL AND METHODS In this retrospective analysis, patients receiving THA via DAA in a single-center hospital from January 2019 to March 2020 were assessed for eligibility and assigned to either a Tri-Lock BPS group or a Corail group based on the use of prostheses. Outcome measures for the efficiency evaluation of the 2 prostheses included perioperative outcomes, imaging results, Harris Hip Score, Western Ontario and McMaster University Osteoarthritis Index, and visual analog scale scores at 3, 6, 12, and 24 months postoperatively. RESULTS A total of 204 patients were included, including 98 patients (98 hips) in the Tri-Lock BPS group and 106 patients (106 hips) in the Corail group. Patients receiving Tri-Lock BPS exhibited better pain relief than those with Coral stems. Tri-Lock BPS had a higher safety profile vs Corail stems by significantly reducing the risk of complications (P=0.004). A markedly increased HHS score (84.42±16.27 vs 78.61±12.78, P=0.002) and a lower WOMAC score (25.08±15.39 vs 32.14±11.56, P=0.001) at 3 months postoperatively were observed in patients with Tri-Lock BPS vs those with Corail stems, indicating better restoration of hip function using Tri-Lock BPS. CONCLUSIONS During total hip arthroplasty via DAA, Tri-Lock BPS causes a smaller surgical wound, reduces the operative time and intraoperative bleeding, and produces less soft-tissue damage vs Corail stems, providing great benefits in femoral prosthesis placement.
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Nooh A, Hart A, Tanzer M. Intermediate to Long-Term Outcomes of a Short, Tapered, Highly Porous, Proximally Coated Cementless Femoral Stem. J Arthroplasty 2023:S0883-5403(23)00351-0. [PMID: 37044224 DOI: 10.1016/j.arth.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Short cementless stems in total hip arthroplasty have gained increasing popularity, yet on-going studies of many of these implants are lacking. The aim of this study was to evaluate the minimum 5 year clinical and radiological results of a short, highly porous single tapered-wedge cementless femoral implant. METHODS A retrospective study of 281 hips in 256 patients who had a minimum 5-year follow-up and underwent primary total hip arthroplasty (THA) between 2010 and 2016 were evaluated. Clinical and radiological results, complications, and the presence of postoperative thigh pain were evaluated. RESULTS The mean follow-up was 8 years (range, 5 to 12 years). Clinically, patients had significant improvement in the average patient related outcome scores (PROMS) postoperatively (Harris Hip Score: pre 47 vs post 95, University of California Los Angeles (UCLA) activity scale: pre 4 vs post 6, Western Ontario and McMaster Universities Arthritis Index (WOMAC): pre 51 vs post 3, SF-12 Physical Component Summary (PCS): pre 32 vs post 52, SF-12 Mental Component Summary (MCS): pre 49 vs post 55 (P<0.001)). Radiographic signs of ingrowth were present in all hips. There were three patients (1.1%) who developed transient thigh pain postoperatively, all of which resolved with non-operative management. CONCLUSION This study provides the longest follow-up of this short, highly porous single tapered-wedge cementless femoral stem in the literature. This short single wedge stem with its highly porous coating demonstrated reproducible bone ingrowth in all patients, and significant functional improvement with a very low rate of transient thigh pain.
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Affiliation(s)
- Anas Nooh
- Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada; Department of Orthopaedic Surgery, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Adam Hart
- Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada
| | - Michael Tanzer
- Division of Orthopaedic Surgery, McGill University, Montreal, QC, Canada.
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Liu B, Wang H, Zhang M, Li J, Zhang N, Luan Y, Fang C, Cheng CK. Capability of auxetic femoral stems to reduce stress shielding after total hip arthroplasty. J Orthop Translat 2023; 38:220-228. [DOI: 10.1016/j.jot.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/05/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
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Sun J, Zhang Y, Shen J, Zheng Q, Li T, Zhang B, Zhou Y, Zhang G. Comparison of Preoperative Computed Tomography and Intraoperative Estimation in Predicting the Version of a Single-Wedge Femoral Stem. Orthop Surg 2022; 14:2979-2986. [PMID: 36177805 PMCID: PMC9627059 DOI: 10.1111/os.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Early prediction of stem version aids in optimization of combined version during total hip arthroplasty (THA). This study aimed to analyze the discrepancy between stem version and native femoral version measured by different methods, and to explore which method can better predict the stem version. Methods We retrospectively reviewed 26 patients (39 hips) treated with robot‐assisted THA in our hospital between September 2019 and December 2019. A straight, single‐wedge, cementless stem (Accolade II) was used in all cases. Preoperative femoral version was measured at three levels on computerized tomography (CT) scan from the top to the middle level of femoral neck (Level 1 to Level 3). During THA, the version on cutting surface was measured prior to femoral broaching based on two reference lines: mid‐cortical line and T line (trochanteric fossa to the middle of medial cortex). After femoral broaching, stem version was measured based on the femoral neck trial using Mako system (Stryker). In the statistical analysis, the difference and absolute discrepancy between stem version and femoral version measured with various methods were examined using paired t‐test, and the relationship between stem version and various femoral versions were examined using correlation analysis. Results Mean femoral neck version (Level 1) was 9.5° ± 2.6° (range, −16.8°‐42.5°), while mean stem version measured by Mako system was 19.9° ± 2.0° (range, −8.0°‐49.0°). Femoral version measured with each method showed a moderate correlation with stem version (p < 0.05). There was a significant difference between stem version and femoral version except at Level 3, with a mean difference of 0.8° ± 13.6° (p = 0.729). With regard to the intraoperative estimation, stem version significantly increased compared to the value based on mid‐cortical line, with a mean difference of 8.4° ± 13.1° (p < 0.001). However, the mean value of stem version was a little smaller than that of femoral version measured by reference to T line, but without statistical significance (p = 0.156). No postoperative dislocations occurred during the study period. No revision was required for any component. Conclusions The middle level of femoral neck on CT scan and T line on cutting surface are better references to measure femoral version for predicting postoperative stem version. However, the relationship between stem version and predictive value was flexible. Therefore, further three‐dimensional studies of postoperative CT are needed to validate the press‐fit fixation and rotational freedom of the single‐wedge stem.
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Affiliation(s)
- Jingyang Sun
- Medical School of Chinese PLA, Beijing, China.,Orthopaedics Department, Peking University Shougang Hospital, Beijing, China
| | - Yanchao Zhang
- Medical School of Chinese PLA, Beijing, China.,Department of Orthopaedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Junmin Shen
- Medical School of Chinese PLA, Beijing, China.,Department of Orthopaedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Qingyuan Zheng
- Medical School of Chinese PLA, Beijing, China.,Department of Orthopaedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Tiejian Li
- Medical School of Chinese PLA, Beijing, China.,Department of Orthopaedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Bohan Zhang
- Medical School of Chinese PLA, Beijing, China.,Department of Orthopaedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Yonggang Zhou
- Department of Orthopaedics, The First Medical Center of PLA General Hospital, Beijing, China.,Department of Orthopaedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
| | - Guoqiang Zhang
- Department of Orthopaedics, The First Medical Center of PLA General Hospital, Beijing, China.,Department of Orthopaedics, The Fourth Medical Center of PLA General Hospital, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, China
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Crown TJL, Sheridan GA, Bengoa F, Fransen BL, Lawlor DK, Clarkson PW, Greidanus NV. Chronic Pseudoaneurysm and Anterior Dislocation After Total Hip Arthroplasty Complicated by Arterial Injury: A Case Report. JBJS Case Connect 2022; 12:01709767-202206000-00039. [PMID: 36099455 DOI: 10.2106/jbjs.cc.22.00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 64-year-old man presented 18 months after total hip arthroplasty complicated by vascular injury with a history of leg pain, inability to mobilize, and progressive chronic leg edema. It is presumed that there was persistent subtle bleeding over time with pseudoaneurysm formation and prosthetic hip dislocation secondary to the mass effect. CONCLUSION Physicians should consider pseudoaneurysm as a possible diagnosis when confronted with a large intra-articular mass in the hip after a relatively short follow-up period, particularly in the context of a prior vascular injury at the time of the index procedure.
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Affiliation(s)
- Taylor J L Crown
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Gerard A Sheridan
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Francisco Bengoa
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Bas L Fransen
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - David K Lawlor
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Paul W Clarkson
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Nelson V Greidanus
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
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Peng L, Ma J, Zeng Y, Wu Y, Si H, Shen B. Clinical and radiological results of high offset tri-lock bone preservation stem in unilateral primary total hip arthroplasty at a minimum follow-up of 3 years. J Orthop Surg Res 2021; 16:635. [PMID: 34689823 PMCID: PMC8543806 DOI: 10.1186/s13018-021-02787-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/11/2021] [Indexed: 02/08/2023] Open
Abstract
Background Although the high offset Tri-Lock bone preservation stem (BPS) was used widely, few studies explored the clinical and radiological results. The purpose of this study was to determine the clinical and radiological results of high offset Tri-Lock BPS in unilateral primary total hip arthroplasty (THA) at a minimum follow-up of 3 years. Methods 55 patients who underwent cementless THA with high offset Tri-lock BPS from 2017 to 2018 were followed for a minimum follow-up of 3 years. Patients were assessed clinically for complications, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Hip Score (OHS). Femoral offset (FO), acetabular offset (AO), hip offset (HO), HO difference, and leg length discrepancy (LLD) were measured on the anteroposterior (AP) pelvic radiograph. Standard pelvic AP and lateral radiographs were used to evaluate for evidence of bone ingrowth, stem subsidence, stem alignment, radiolucent line around the stem, osteolysis, loosening, ectopic ossification, and femoral stress shielding. Results No patients reported complications during hospitalization nor the follow-up period. At a mean follow-up of 42.5 months, the mean HHS, WOMAC, and OHS scores showed a significant improvement from preoperative to the latest follow-up. No patients reported thigh pain. No revision nor sign of radiographic loosening had been detected. The high offset Tri-Lock BPS significantly improved the FO and HO postoperatively. HO difference and LLD were balanced postoperatively. No sign of stem subsidence, radiolucent line, osteolysis, loosening, ectopic ossification, nor severe stress shielding (more than grade 3–4) were observed at the latest follow-up. Conclusion The high offset Tri-Lock BPS demonstrated excellent clinical and radiographic outcomes at a minimum follow-up of 3 years. HO difference and LLD between legs decreased significantly and achieved balance postoperatively. Long-term follow-up is required for a definitive conclusion.
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Affiliation(s)
- Linbo Peng
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Jun Ma
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yi Zeng
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yuangang Wu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Haibo Si
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Bin Shen
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China.
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