Total hip replacement with an uncemented Wagner cone stem for patients with congenital hip dysplasia

Abstract

Purpose The purpose of this study was to review retrospectively the cases operated upon in our department in recent years with a Wagner stem and a small socket in cases of Crowe I or II dysplastic hips. Methods We conducted a retrospective clinical radiological review of 30 hips diagnosed with hip dysplasia Crowe I or II treated in our centre between 2002 and 2008. All of them were treated with a Wagner cone stem and a small Trilogy acetabulum (Zimmer ®). Results There were 15 men and 11 women with 13 left and 17 right femurs. Mean follow-up was 43.44 months (range 14-87). Eight patients were Crowe I type and 22 were Crowe II type. Merlé d'Aubigne score pre-operatively was 12.23 and at the last follow-up was 15.54. Mean leg length inequality was 1.79 and after surgery it was 0.69 cm. Complications included three infection and three dislocations (two of them in the same patient). Conclusions The use of a Wagner stem is a good option to correct the different deformities in the proximal femur in these cases. A small socket allows a correct relocation of the acetabulum in a dysplastic socket with good bone coverage.

The Use of a Cementless Tapered Stem in Young Patients Affected of Secondary Hip Arthritis

“…Our results are consistent with other previous published studies both in short and long terms [7][8][9][10][11][12][13].…”

Can a Conical Implant Successfully Address Complex Anatomy in Primary THA? Radiographs and Hip Scores at Early Followup

“…The patients in this study should comparable improvement in their hip scores compared to previous reports of patients who underwent complex, primary, cementless, total hip arthroplasty with conical prostheses as well as modular prostheses [1,2,6,8,11,15,19,27,28,30,31]. Despite predictable success with similar stems, it remains critically important to systematically report clinical and radiographic results whenever new technology is introduced.…”

“…The Wagner Cone stem can accommodate small or deformed femora because of its proximal conical, tapered design. This design facilitates adjustment of stem position in hips with excessive native femoral anteversion, a point noted previously [1,27]. However, to our knowledge, no studies have evaluated this implant's results in a series of difficult primary THAs.…”

“…Like the former two types of stems, these taper stems can also achieve satisfactory long-term results with an incidence of thigh pain as low as 2% to 4% [4,12]. The taper cone prosthesis has a narrow round proximal cross-section that facilitates adjustment of the anteversion angle; this implant design is ideal for the femur with proximal femoral deformity such as developmental dysplasia of the hip (DDH) [1,8,15,27,28,31].…”

Total Hip Replacement in Developmental Dysplasia of the Hip Using Wagner Cone Prosthesis with Small Diameter Metal-On-Metal Articulation

“…As far as we know, very few studies have looked at the results of using this stem with small diameter MoM bearings for dysplastic hips. Recently Claramunt et al [9] presented a series of 30 hips treated with this kind of stem with very good clinical and radiological results at 43 months of follow up. The bearing surfaces used in the study were not described.…”