Follow-Up Results of 10-12 Years After Total Hip Arthroplasty Using Cementless Tapered Stem 鈥?Frequency of Severe Stress Shielding With Synergy Stem in Japanese Patients

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• 作者：Tomofumi Nishino ; Hajime Mishima ; Haruo Kawamura ; Yukiyo Shimizu ; Syumpei Miyakawa ; Naoyuki Ochiai
• 关键词：tapered stem ; stress shielding ; total hip arthroplasty ; distal fixation
• 刊名：The Journal of Arthroplasty
• 出版年：December, 2013
• 年：2013
• 卷：28
• 期：10
• 页码：1736-1740
• 全文大小：1086 K

文摘

Synergy stems are tapered stems featuring a proximal porous coating, grid blasting below the proximal third to the distal end. This study included 41 patients (50 hips) who underwent total hip arthroplasty with follow-ups for 10 years or more. No stem reimplantations were performed. Spot welds were observed in the distal stem in Gruen zones 3 and 5 in 35 and 32 hips, respectively. First-degree stress shielding occurred in 8 hips; 2nd-degree, 20 hips; 3rd-degree, 13 hips; and 4th-degree, 9 hips. Because of bone fixation to the distal grit-blasted section of the stem, severe stress shielding was observed in nearly half of the cases. Multiple regression analysis of stress shielding determinants revealed a correlation between stem size and short patient height, showing the cause of stress shielding to be a mismatch in size between the stem and the femoral bone.