Proximally Coated Cementless Bipolar Hemiarthroplasty in Dorr Type C Bone

Bonutti, Peter M.; Stroh, Alex D; Issa, Kimona; Harwin, Steven F.; Patel, Dipak V.; Mont, Michael A.

doi:10.3928/01477447-20140401-54

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…Previous studies showed favorable results of conventional cementless stems for femoral neck fractures4567). Proximal wedged stems also showed favorable results for osteoporotic bone without signs of early subsidence19).…”

Section: Discussionmentioning

confidence: 99%

“…The use of cementless stems for femoral neck fractures has remarkably increased in the last decade23). Previously, full-coated tapered stems or conventional proximal tapered stems showed favorable results for femoral neck fractures4567). However, concerns remain about the use of conventional cementless stems because of thigh pain due to diaphyseal fixation and risk of unexpected bone loss due to the morphology of the stem89).…”

Section: Introductionmentioning

confidence: 99%

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Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Lee

Yoon

2019

Hip & Pelvis

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PurposeShort stems have recently become widely used; however, concerns about the initial secure fixation of a short stem in osteoporotic bone remain. The aim of this study was to evaluate the short-term clinical and radiological results of using a short cementless metaphyseal stabilizing tapered stem for senile osteoporotic femoral neck fractures.Materials and MethodsThirty-eight arthroplasties (31 bipolar hemiarthroplasties and 7 total hip arthroplasties) were performed for osteoporotic femoral neck fractures in patients older than 65 years (10 males and 28 females). The mean age was 76.1 years and the mean follow-up was 2.9 years. We retrospectively evaluated clinical results, focusing on walking performance, thigh pain, and radiologic results, with special regard to signs of stem stability and osteointegration.ResultsMean Harris hip score was 84.3 points and 68.4% of patients regained their preoperative walking performance. No patients complained about thigh pain. No osteolysis or loosening was observed during the follow-up, and all but 1 stem showed signs of stable bone ingrowth.ConclusionShort, metaphyseal stabilizing tapered stems could be a reliable treatment option for osteoporotic femoral neck fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Lee

Yoon

2019

Hip & Pelvis

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“…Uncemented femoral component, regardless of collared or uncollared, can provide primary stability and achieve favorable clinical outcomes in Dorr type C bone [24][25][26]. However, the relationship between IPI and proximal femoral morphology has not been well established.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis

Qiu

Chen

et al. 2020

J Orthop Surg Res

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Background The relationship between collar design of a femoral component and iliopsoas impingement (IPI) after total hip arthroplasty (THA) is still underrecognized. The purpose of our study was to determine the possible risk factors for IPI related to the femoral component, when using a collared femoral prosthesis. Methods A total of 196 consecutive THA patients (206 hips) using a collared femoral prosthesis were reviewed retrospectively after exclusion of the factors related to acetabular component and femoral head. The patients were divided into +IPI and −IPI group according to the presence of IPI. Radiological evaluations were performed including femoral morphology, stem positioning, and collar protrusion length (CPL). Multivariate regression analysis was performed to assess the risk factors for IPI. Results At a minimum follow-up of 1 year, IPI was observed in 15 hips (7.3%). Dorr type C proximal femur was found in nine hips (60%) in the +IPI group and in 28 hips in the −IPI group (14.7%, p < 0.001). The mean stem anteversion in the +IPI group was significantly greater than that in the −IPI group (19.1° vs. 15.2°, p < 0.001), as well as the mean CPL (2.6 mm vs. − 0.5 mm, p < 0.001). The increased stem anteversion ( OR = 1.745, p = 0.001) and CPL ( OR = 13.889, p = 0.001) were potential risk factors for IPI. Conclusions The incidence of IPI after THA is higher than expected when using a collared femoral prosthesis. Among the factors related to collared femoral prosthesis, excessively increased stem anteversion and prominent collar protrusion are independent predictors for IPI. In addition, high risk of IPI should be carefully considered in Dorr type C bone, despite that femoral morphology is not a predictive factor. Level of evidence Level IV, clinical cohort study

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A high risk of postoperative periprosthetic femoral fracture in Dorr type C femurs: a retrospective cohort study with 10-year follow-up data and a preliminary monochromatic image analysis

Li,

Zeng,

Nie

et al. 2023

International Journal of Surgery

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Background: We applied Anatomique Benoist Girard II (ABG II) stems for total hip arthroplasty (THA) in some Dorr type C femurs as early attempts. Here, we compared the long-term follow-up results between ABG II stems and the “well-performing” Corail stems and their monochromatic images. Methods: Among 3214 primary THA records, 43 short ABG II stems and 67 standard-length Corail stems implanted in Dorr type C femurs were eligible and enrolled in this retrospective cohort study, with a mean follow-up of 10.3 years. Revision rates, Harris hip scores, and radiologic signs were compared. Spectral CT scans from a representative sample were obtained, and monochromatic images were reconstructed. A quantitative method was developed to measure the volume of the gap around stems. Patient-specific finite element analysis was conducted to investigate the strains. Results: The revision rate of ABG II stems was significantly higher than that of Corail stems (21% vs. 3%, P<0.05). In the monochromatic images, fewer spot-weld signs (2.15 vs. 3.38, P<0.05) and wider gaps around stems (1.64 cm3 vs. 0.13 cm3, P<0.05) were observed on average in the ABG II group. The mean maximum principal strains of the proximal femurs in the ABG II group were close to the yield strains and significantly larger than those in the Corail group (0.0052 vs. 0.0011, P<0.05). Conclusions: There was a high risk of postoperative periprosthetic femoral fracture for ABG II stems in Dorr type C femurs. Monochromatic images provided some insight into the failure mechanism. Level of Evidence: III

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Proximally Coated Cementless Bipolar Hemiarthroplasty in Dorr Type C Bone

Cited by 5 publications

References 21 publications

Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Favorable Functional Recovery and Stem Stability after Hip Arthroplasty with a Short Metaphyseal Stem in Elderly Patients with Osteoporotic Femoral Neck Fractures

Risk factors for iliopsoas impingement after total hip arthroplasty using a collared femoral prosthesis

A high risk of postoperative periprosthetic femoral fracture in Dorr type C femurs: a retrospective cohort study with 10-year follow-up data and a preliminary monochromatic image analysis

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