Clinical and Radiological Outcomes of Rectangular Tapered Cementless Stem According to Proximal Femoral Geometry in Elderly Asian Patients

Abstract

Purpose: A retrospective analysis of mid-to long-term clinical and radiological outcomes of Korean patients over 60 years of age who underwent hip arthroplasty using a cementless rectangular tapered stem according to Dorr proximal femur geography. patients (112 hips) underwent hip arthroplasty using the C2 stem. The mean age of patients was 77.4 years (range, 60-91 years) and the mean follow-up duration was 91.1 months (range, 60-116 months). All patients were evaluated clinically and radiologically with special attention to Dorr femoral bone classification, implant fixation, radiolucent line (RLL), and thigh pain. Results: All implants demonstrated radiographic evidence of stable fixation by bone ingrowth without any change in position. The mean Harris hip score improved from 65.5±16.0 (preoperative) to 90.5±15.9 (final follow-up) (P<0.001). Incidence of RLLs, stress shielding, and thigh pain was highest in patients with Dorr type A (RLL, P=0.021; stress shielding, P=0.030; thigh pain, P<0.001). One stem revision was performed due to deep infection. The Kaplan-Meier survival rate of the femoral stem was 97.6%. Conclusion: The overall survival rate of the C2 stems was greater than 97%; there were no significant differences in survival of the C2 stem according to the Dorr classification. The incidences of RLL of thigh pain and RLL were significantly different among Dorr classifications and (highest in patients with Dorr type A). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons. org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Results of Hip Arthroplasty Using a COREN Stem at a Minimum of Ten Years

“…A C2 stem (Lima Corporate SpA, Udine, Italy) was used in our previous study; the results showed more frequent occurrence of RLL and thigh pain in patients with Dorr type A 18) . The design of the C2 stem is similar to that of the COREN stem; a rectangular tapered stem with proximal fitting.…”

“…In this study, relief of thigh pain was achieved within two years after surgery without complications in all patients. Although the cause of the pain relief may be uncertain, previous studies reported that relief of thigh pain was achieved with time 8 18) .…”

Midterm outcome analysis of bipolar hemiarthroplasty for unstable intertrochanteric femur fractures: A retrospective study

“…Kang et al performed hip arthroplasty using a type 3C stem and reported radiological results after more than five years [32]. Of the 112 cases followed up, 15 cases (13.4%) showed a radiolucent line, and there were significant cases of lack of calcar filling (p = 0.033), which may occur when the calcar fill is insufficient, as the proximal femoral region is wide in the case of a Dorr A type femur.…”

“…Of the 112 cases followed up, 15 cases (13.4%) showed a radiolucent line, and there were significant cases of lack of calcar filling (p = 0.033), which may occur when the calcar fill is insufficient, as the proximal femoral region is wide in the case of a Dorr A type femur. The fine motion of the femoral stem causes bone resorption, and the fibrous membrane fills the gap between the femoral stem and inner cortex, which appears radiolucent on plain radiography [32]. Furthermore, Lutz et al, performed hip arthroplasty using a type 3C stem and analyzed the clinical and radiological outcomes determined by CT-assisted osteodensitometry of bone mineral density and bone mineral changes of the femoral cortical and cancellous bone [33].…”