Does the Canal Fill Ratio and Femoral Morphology of Asian Females Influence Early Radiographic Outcomes of Total Hip Arthroplasty With an Uncemented Proximally Coated, Tapered-Wedge Stem?

Ishii, Satoko; Homma, Yasuhiro; Baba, Tomonori; Ozaki, Yu; Matsumoto, M; Kaneko, Kazuo

doi:10.1016/j.arth.2016.01.016

Cited by 61 publications

(54 citation statements)

References 13 publications

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“…(10) Ishii et al opined that in Asians, this was due to a smaller femoral canal size, causing distal fixation in champagne-flute morphology femurs. (11) In octogenarians, canal flaring changes asymmetrically, with increased medial flaring and less lateral flaring. (12) Our results showed that there was no correlation between BMD of the hip and CC ratio.…”

Section: Discussionmentioning

confidence: 99%

Radiographic study of the proximal femur morphology of elderly patients with femoral neck fractures: is there a difference among ethnic groups?

Tang

Yeoh

Tan

2017

smedj

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INTRODUCTIONThis study aimed to determine ethnic differences in the proximal femur morphology of elderly patients with femoral neck fractures in Singapore. CONCLUSION We found statistically significant differences in the femoral head sizes and calcar-to-canal width ratios among women of different ethnic groups. There were also differences in neck-shaft angles between Chinese and Indian women, and between Malay and Indian women. METHODS

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Section: Discussionmentioning

confidence: 99%

Radiographic study of the proximal femur morphology of elderly patients with femoral neck fractures: is there a difference among ethnic groups?

Tang

Yeoh

Tan

2017

smedj

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“…Preoperative planning with knowledge of this complication will contribute to an improved postoperative course for both surgeons and patients. Originally, the proximally coated tapered stem was designed to obtain mechanical and biological fixation at the proximal part of the stem and to decrease the fill ratio at the distal part of the stem [3]. However, the femoral canal is narrow in some patients, leading to a full distal canal even when a tapered stem is implanted.…”

Section: Discussionmentioning

confidence: 99%

“…In general, the proximally coated tapered cementless stem is aimed to have mechanical and biological fixation at the proximal part of the femur. However, the proximal-distal mismatch can occur when the stem does not meet the intended mechanical fixation pattern, where the proximally coated tapered stem is fixed at the distal area [3,4]. In such cases, optimal biological fixation does not occur, resulting in early symptomatic aseptic loosening.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of and Early Revision Surgery for Biological Fixation Failure Due to Proximal-Distal Mismatch of Proximally Coated Tapered Cementless Stem

et al. 2020

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The diagnosis of and decision-making for early revision surgery to treat failure of biological fixation with a proximally coated cementless stem are challenging. A 73-year-old woman was referred to our hospital with thigh pain 2 years after the initial total hip arthroplasty. Although a plain radiograph showed no signs indicating biological fixation failure, digital tomosynthesis showed a highly radiodense line along the proximal part, and bone scintigraphy showed uptake at the distal part. With the diagnosis of biological fixation failure due to the proximal-distal mismatch, the cementless stem was revised to a cemented stem, and the thigh pain was improved after the revision surgery. Digital tomosynthesis and bone scintigraphy can be helpful for the diagnosis of biological fixation failure due to proximal-distal mismatch.

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“…The success of cementless THA depends on a close geometric t between the prosthesis and bone in order to achieve optimal primary stability and secondary biologic xation [2]. Modern cementless prothesis stems engage the medial and lateral cortices of the femoral medullary metaphysis through a tapered wedge, and match the metaphyseal medullary cavity morphology as much as possible [3]. Insu cient matching may lead to loosening of the prosthesis due to a lack of proximal osseointegration [4].…”

Section: Introductionmentioning

confidence: 99%

Ct Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects From Northern China

Zhao

Chen²,

Tian

et al. 2020

Preprint

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Background In total hip arthroplasty (THA), optimal stability and fixation is achieved via tight adaptation of the prosthesis to the bone. This study aimed to analyze the proximal femoral medullary cavity morphology of Chinese subjects on three-dimensional reconstructed imagery to explore the factors influencing these parameters. Methods CT was performed on 63 healthy subjects from northern China (94 hips; 31 men, 63 women). Three-dimensional CT reconstruction of the proximal femoral medullary cavity was performed using Mimics 22.0 software. The anatomical parameters related to THA were measured to examine the relationships between sex, age, and femoral length. These parameters were compared with previously published data. Results The internal and external coronal diameters of the femoral medullary cavity, and the anterior and posterior sagittal diameters had different contracting trends. There were correlations between the femoral length, femoral head diameter, and coronal diameter, and between the sagittal diameter and cross-sectional area of the medullary cavity. Age was negatively correlated with the CFI. Sex was correlated with the cross-sectional coronal/sagittal diameters, but not with the canal flare index. The proximal end of the medullary cavity was similar to that reported in Caucasians, but the Asian medullary cavity was narrower distal to the level of the lesser trochanteric line. Conclusion THA-related anatomy was affected by sex, age, and subpopulation. Compared with sex, age had a greater effect on the fit of the stem to the femoral canal. Each patient must be treated individually, as the anatomical structure varied between individuals.

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Does the Canal Fill Ratio and Femoral Morphology of Asian Females Influence Early Radiographic Outcomes of Total Hip Arthroplasty With an Uncemented Proximally Coated, Tapered-Wedge Stem?

Cited by 61 publications

References 13 publications

Radiographic study of the proximal femur morphology of elderly patients with femoral neck fractures: is there a difference among ethnic groups?

Radiographic study of the proximal femur morphology of elderly patients with femoral neck fractures: is there a difference among ethnic groups?

Diagnosis of and Early Revision Surgery for Biological Fixation Failure Due to Proximal-Distal Mismatch of Proximally Coated Tapered Cementless Stem

Ct Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects From Northern China

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