Does the Canal Fill Ratio and Femoral Morphology of Asian Females Influence Early Radiographic Outcomes of Total Hip Arthroplasty With an Uncemented Proximally Coated, Tapered-Wedge Stem?

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• 作者：Seiya Ishii ; MD ; Yasuhiro Homma ; MD ; PhD ; Tomonori Baba ; MD ; PhD ; Yu Ozaki ; MD ; Mikio Matsumoto ; MD ; Kazuo Kaneko ; MD ; PhD
• 关键词：total hip arthroplasty ; noncemented stem ; femur morphology ; osteointegration ; distal hypertrophy
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：31
• 期：7
• 页码：1524-1528
• 全文大小：792 K

文摘

Noncement femoral fixation in total hip arthroplasty (THA) has been gaining popularity. However, owing to the numerous varieties of uncemented stems and differing types of femoral stem morphology, it is unclear whether the clinical outcomes of all uncemented stems are equal. The aim of this study was to investigate the relationships between canal fill ratio and femoral morphology and early radiologic outcomes in Japanese patients who underwent THA with an uncemented proximally hydroxyapatite-coated, tapered-wedge stem.

Methods

We retrospectively reviewed 103 patients who had undergone THA using a single proximally coated tapered-wedge stem. The relationships between canal fill ratio and femoral morphology and early radiologic outcomes after THA with those stem were investigated.

Results

Eighty-one hips were analyzed after inclusion and exclusion criteria were applied. Failed osteointegration proximally was observed in 4 hips (4.9%). Canal flare index was significantly greater in hips with failed osteointegration than in those with successful osteointegration (P = .009). Distal hypertrophy was observed in 14 hips (17.3%). Proximal-distal matching ratio was significantly lower in hips with distal hypertrophy than in those without (P = .01). Canal fill ratio at 2 cm above the lesser trochanter was smaller in hips with failed osteointegration and distal hypertrophy than in those without (P = .02).

Conclusion

Suboptimal radiologic changes were seen with greater distal fill with smaller proximal fill and with a narrow femoral canal. It is important to select the stem that can achieve the original concept of intended primary and secondary fixation areas.