Use of a Hydroxyapatite-coated Stem in Patients with Dorr Type C Femoral Bone

Kelly, Stephen; Robbins, Claire E.; Bierbaum, Benjamin E.; Bono, James V.; Ward, Daniel M.

doi:10.1097/blo.0b013e318156bf96

Cited by 43 publications

(24 citation statements)

References 15 publications

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“…Kelly et al 12 demonstrated good results over nine to 14 years of postoperative follow-up on 15 patients with Dorr type C femoral morphology. These authors used an uncemented femoral component coated with hydroxyapatite.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of the results from proximal fixation of uncemented conical femoral components in Dorr type C femurs

Hatem

Luz

Nishi

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the results from proximal fixation of uncemented conical femoral components in patients with a type C proximal femur and compare them with the results obtained from type A and B femurs.MethodsThis was a retrospective study on 87 patients with 90 uncemented total hip arthroplasty procedures. Three patients (three hips) were excluded because their follow-up lasted for less than two years. The follow-up ranged from 2 to 4.3 years and the mean was 2.8 years. The Bicontact femoral implant model was used. The preoperative radiographs were evaluated, the femurs were classified as Dorr types A, B or C and the cortical indices were measured. The patients were evaluated clinically by means of the Harris Hip Score (HHS), before the surgery and at the last follow-up. The sequences of postoperative radiographs were compared regarding stability, complications and any signs of osseointegration of the femoral prosthesis.ResultsAmong the 87 hips with follow-up greater than two years, 32 femurs were type A (37%), 37 type B (42%) and 18 type C (21%). Before the operation, the mean HHS was 39.4 for types A and B and 38.8 for type C. At the last follow-up, the mean HHS was 89.8 for types A and B and 86 for type C. None of the 87 femoral components had been revised by the time of the last follow-up; all of them were considered stable. In 86 cases, the radiographs showed signs of osseointegration.ConclusionThere were no significant differences in the clinical results or in the fixation (and osseointegration) of conical uncemented femoral prostheses with proximal porosity, among femurs with different types of femoral morphology according to the Dorr classification. This conclusion may vary if another implant model were to be used.

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Section: Discussionmentioning

confidence: 97%

Evaluation of the results from proximal fixation of uncemented conical femoral components in Dorr type C femurs

Hatem

Luz

Nishi

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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“…Bicontact stem is classified as single wedge (Type 1) stem that obtains initial stability by engaging metaphyseal cortical bone. Although cementless stems have generally been considered unsuitable for Dorr Type C femurs, they have been tried on Dorr C femurs with excellent results in long term followups of more than 10-years323334 [Table 3]. For single wedge stem, McLaughlin and Lee compared the survivorship of Taperloc stem (Biomet, Warsaw, IN) in Dorr Type C femur to that in Dorr Type A and B femur after mean 16.6-year followup 6.…”

Section: Discussionmentioning

confidence: 99%

Does Proximally Coated Single-Wedge Cementless Stem Work Well in Dorr Type C Femurs? Minimum 10-year Followup

Kim

Jeong

Lee

et al. 2019

IJOO

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Background: Total hip arthroplasty (THA) with a proximally coated single-wedge (PSW) cementless stem had been generally considered not to be suitable for Dorr Type C femurs. This study compares the long term outcomes of PSW stem according to the type of proximal femoral geometry. Materials and Methods: 307 primary THAs in 247 patients were performed with PSW cementless stem and followed up for over 10 years in this retrospective study. According to Dorr's criteria, 89 femurs were classified as Type A, 156 as Type B, and 62 as Type C. They were followed up for an average of 13.2 years (range 10.0–17.3 years). All the hips were evaluated clinically and radiologically. Results: There was no significant difference in stem survivorship and clinical outcomes including the incidence of thigh pain and the mean postoperative Harris hip score (HHS) in all three groups. No significant differences were observed in osteolysis, pedestal formation, or cortical hypertrophy among the groups. Radiolucent lines <2 mm in thickness in Gruen zone 4 and 7 ( P = 0.003 and P = 0.044, respectively), spot-weld ( P < 0.001), and stress shielding ( P = 0.010) of proximal femur were more pronounced in Dorr C type femora than in Type A or B. Fifty-six intraoperative fractures were identified among 307 hips with PSW stems. The incidence of intraoperative or postoperative femoral fractures was not significantly different among the groups. Conclusions: From over a 10-year followup, the PSW stem provided a recommendable option with satisfactory outcomes and excellent stem survivorship regardless of the Dorr type.

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“…With recent improvements in uncemented fixation and developmental progress in the prosthesis structure, several groups have suggested the use of cementless femoral components in porotic bone. Kelly et al [ 22 ] reported high clinical scores (median Harris hip score, 94.5) and no femoral fixation failures in 15 Class C (osteoporotic) bone patients with a minimum of a 9-year follow-up (average, 11.5 years; range, 9–14 years) and the use of a hydroxyapatite-coated cemented stem.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Simultaneous Femoral Neck Fracture Mimicking Abdominal Pain in a Cerebral Palsy Patient

Mariani

Buttaro

Zanotti

et al. 2014

Case Reports in Orthopedics

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Simultaneous bilateral femoral neck fractures are unusual lesions, generally associated with an underlying condition which causes impaired bone mineralization, triggered by an increased bone stress. We present a 24-year-old cerebral palsy patient, who was previously evaluated in another institution due to inability to walk, interpreted as abdominal pain. No alteration in blood analysis or abdominal X-rays was found. As no response to treatment was observed, a new abdominal X-ray was taken, which incidentally depicted bilateral medial femoral neck fracture. He was referred to our practice after a resection arthroplasty was offered in another institution. After admission, bilateral one-stage THA was performed. Several reports emphasize bone disease as a major precipitating factor, and there is an increased incidence of hip fractures in chronic epilepsy, renal osteodystrophy, and chronic steroid use. Femoral head resection has been proven to be effective in immobilized patients, whereas this was not a reasonable option in this patient who presented walking ability. Despite the treatment election, primary care physicians should be aware of and alert to the possibility of fractures in patients with neurological disorders and calcium metabolism alterations. Late diagnosis of orthopedic injuries in this type of patients may lead to permanent disability.

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Use of a Hydroxyapatite-coated Stem in Patients with Dorr Type C Femoral Bone

Cited by 43 publications

References 15 publications

Evaluation of the results from proximal fixation of uncemented conical femoral components in Dorr type C femurs

Evaluation of the results from proximal fixation of uncemented conical femoral components in Dorr type C femurs

Does Proximally Coated Single-Wedge Cementless Stem Work Well in Dorr Type C Femurs? Minimum 10-year Followup

Bilateral Simultaneous Femoral Neck Fracture Mimicking Abdominal Pain in a Cerebral Palsy Patient

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