Dual offset metaphyseal-filling stems in primary total hip arthroplasty in dysplastic hips after a minimum follow-up of ten years

Dikmen, Göksel; Özden, Vahit Emre; Beksaç, Burak; Tözün, I. Remzi

doi:10.1007/s00264-018-4161-y

Cited by 7 publications

(17 citation statements)

References 39 publications

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“…The results provided by this study confirm the good long-term outcomes achieved with anatomic and tapered stems in DDH, in agreement with previous reports [ 14 – 16 ]. As NM-ANAT and NM-TAP stems may only partially address high femoral antetorsion, small-sized femurs, and proximal–distal mismatches, these implants should be limited to modest dysplastic anatomies [ 14 , 16 ]. The modular options may provide some benefits, but some device-specific complications may be encountered [ 14 , 17 ].…”

Section: Discussionsupporting

confidence: 93%

Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study

et al. 2021

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Introduction Total hip arthroplasty (THA) in dysplastic hips is challenging, and each specific implant used in this context has been associated with specific complications. A registry study was performed to query survival rates, hazard ratios, and reasons for revision of different stem designs in THAs after developmental dysplasia of the hip. Materials and methods A regional arthroplasty registry was inquired about cementless THAs performed for hip dysplasia from 2000 to 2017. Patients were stratified according to stem design in tapered (TAP; wedge and rectangular), anatomic (ANAT), and conical (CON), and divided on the basis of modularity (modular, M; nonmodular, NM). In total, 2039 TAP stems (548 M and 1491 NM), 1435 ANAT (1072 M and 363 NM), and 2287 CON (1020 M and 1267 NM) implants were included. Survival rates and reasons for revisions were compared. Results The groups were homogeneous for demographics, but not fully comparable in terms of implant features. NM-CON stems showed the highest risk of failure (significant) and a high risk for cup aseptic loosening (2.5%). The adjusted risk ratio showed that NM-CON was more prone to failure (HR versus NM-ANAT: 3.30; 95%CI 1.64–7.87; p = 0.0003). Revision rates for dislocations and stem aseptic loosening did not differ between cohorts. Conclusions NM-CON stems showed the highest risk of failure, especially high rates of cup aseptic loosening. NM-CON implants were not more prone to dislocations and stem aseptic loosening. Clinical comparative studies are required to investigate the causes of NM-CON failures, which may be due to abnormal acetabular morphology or imperfect restoration of the proximal biomechanics.

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Section: Discussionsupporting

confidence: 93%

Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study

et al. 2021

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“…No stem showed aseptic loosening, and the JOA score improved significantly. Several reports [ [6] , [7] , [8] , [9] ] show the excellent survivorship of fit-and-fill stems, and the outcomes of our study regarding the short-stem variation are in keeping with the results of these reports. Unfortunately, the severity of stress shielding in the mid-term results of our study was similar to that of a previous report [ 10 ] in the Japanese population.…”

Section: Discussionsupporting

confidence: 91%

“…Fit-and-fill stems are known for their excellent stability and low frequency of thigh pain postoperatively [ [6] , [7] , [8] , [9] ]. However, severe and progressive stress shielding has been reported in the Japanese population [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations

et al. 2022

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“…[ 1 ] Although a shortening osteotomy is mostly indispensable for high riding hips,[ 2 ] a less severe displacement of femoral head as in Crowe type 2 or 3 may be addressed successfully with THA without a shortening osteotomy. [ 3 ] Dysplasia and superior migration of the femoral head make the surgical application of THA challenging in these patients. Previous studies have investigated different femoral stem options in mixed types of dysplasia cohorts or solely in osteotomized hips.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have investigated different femoral stem options in mixed types of dysplasia cohorts or solely in osteotomized hips. [ 4 , 5 ]…”

Section: Introductionmentioning

confidence: 99%

The round femoral stem provides a similar clinical outcome but more serious proximal stress shielding compared to the rectangular stem in cementless total hip arthroplasty without a shortening osteotomy in patients with Crowe type 2 or 3 hip dysplasia

Kayaalp¹,

Erdoğan

Kaynak

2022

Jt Dis Relat Surg

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Objectives This study aims to compare clinical and radiological follow-up results of a rectangular (SL-Plus®) or a round (Synergy®) femoral component in patients with Crowe type 2 or 3 hip dysplasia operated with total hip arthroplasty (THA) without a shortening osteotomy. Patients and methods Between January 2012 and December 2017, a total of 34 hips of 30 female patients (mean age: 42.9±11.6 years; range, 24 to 66 years) were retrospectively analyzed. All patients were evaluated using the Harris Hip Score (HHS) and Visual Analog Scale (VAS) for pain pre- and postoperatively. Intra- and postoperative complications were noted. Evaluation criteria included leg length discrepancy, stem subsidence, bone atrophy or hypertrophy around the stem according to Gruen zones, operative time, and intraoperative blood loss. Correlation analysis of radiological, clinical findings, and stem size was performed. Results The mean follow-up was 61.3±27.2 months. The mean postoperative HHS was 89.3±6.2 vs. 93.1±9.1, and the mean VAS score 1±0.6 vs. 1±0.8 in round and rectangular stem groups at the final follow-up. No significant differences were detected between the groups in any of the evaluated parameters, except for a more severe degree of stress shielding observed in the round stem group. Round stem size was positively correlated with a more severe stress shielding (r=0.55, p=0.020). No patient had to be revised during the follow-up period. The overall complication rate was 9%. Conclusion Successful and comparable results can be obtained with cementless THA in patients with high riding dysplastic hips implanting either of the femoral components, a rectangular or a round stem. Although the round stem was associated with more common proximal stress shielding, this was not associated with worse clinical outcomes.

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Dual offset metaphyseal-filling stems in primary total hip arthroplasty in dysplastic hips after a minimum follow-up of ten years

Cited by 7 publications

References 39 publications

Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study

Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study

Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations

The round femoral stem provides a similar clinical outcome but more serious proximal stress shielding compared to the rectangular stem in cementless total hip arthroplasty without a shortening osteotomy in patients with Crowe type 2 or 3 hip dysplasia

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