Hip resurfacing arthroplasty for patients with inflammatory arthritis: a systematic review

Morse, Kyle W.; Su, Edwin P.

doi:10.5301/hipint.5000558

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…To address this difficult issue, a case series was performed with many other choices of hip arthroplasty or other types of femur stems to address Dorr C osteoporotic bone in young adults [ 32 , 33 ]. Total hip resurfacing arthroplasty is a good alternative to conventional total hip arthroplasty and can provide excellent results in terms of implant survivorship after careful patient selection [ 41 , 42 ]. However, the poor bone mineral density may contribute to increased fractures of the femoral neck and head or pathological fractures in patients with severe osteoporosis, particularly in patients comorbid with rheumatologic disorders [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Osteopenia or weakness of the femoral head may lead to femoral component loosening because it is mechanically unfavorable to have resistance on the femoral head and neck by stresses transmitted through the implant. Meanwhile, hip resurfacing arthroplasty is not indicated in young women who wish to become pregnant in the future as pregnancy-related complications and adverse effects of metal on metal debris on the fetus are unknown [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…Note the radiographic signs of calcar rounding and the increase in bone density in this area. No component migrated superiorly or medially pregnancy-related complications and adverse effects of metal on metal debris on the fetus are unknown [42].…”

Section: Discussionmentioning

confidence: 99%

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Primary total hip arthroplasty using a short bone-conserving stem in young adult osteoporotic patients with Dorr type C femoral bone

Peng¹,

Chang²,

Yue

et al. 2021

J Orthop Surg Res

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Background Dorr type C femoral bone exhibits a wide, stovepipe-shaped femoral canal, and thin cortices in the proximal femur. Dorr C bone combined with severe osteoporosis is an important challenge in primary hip arthroplasty. In this study, we assessed the effects of short metaphyseal fitting cementless stems on preformatted primary total hip arthroplasties in young adult osteoporotic patients with this femoral presentation. Methods A total of 42 hip arthroplasties were performed in 35 young patients (range 20 to 36 years) using a short Tri-lock bone preservation metaphyseal-fitting cementless femoral component between 2012 and 2017. The mean age at surgery of the 27 male (33 hips) and 8 female (9 hips) patients was 27.5 years (range 20.3 to 35.8 years). The mean body mass index (BMI) was 20.2 kg/m2 (range, 16.8–23.2 kg/m2). According to Dorr’s criteria, all 42 femora were classified as type C bone and all femurs suffered from severe osteoporosis (Singh index ≤ 3). Results The mean follow-up period was 5.5 years (range 3.0 to 8.0 years). The clinical and functional results improved for the Harris hip score, WOMAC, and UCLA activity scores. The Harris Hip score improved from 48.0 ± 8.0 (range 38.0 to 61.0) preoperatively to 87.0 ± 9.0 (range 77.0 to 92.0) at 12 months after surgery and 91.0 ± 8.0 (range 85.0 to 98.0) at final follow-up. The preoperative UCLA activity score was 3.0 ± 0.5 points (range, 1.0–4.0 points), which significantly improved to 7.5 ± 0.7 points (range 6.0 to 8.0 points) at the final follow-up. No patient exhibited thigh pain at the final follow-up. The mean stem-to-canal fill percentages were 97% ± 2.1% (anteroposterior view at midstem). For stem alignment, 40 hips (95.2%) of the femoral stem were positioned neutrally to 3° of varus with reference to the femoral shaft axis. The remaining two were positioned at 4° varus to 4° valgus. Radiographic evaluation showed good osteointegration of the implants in follow-up. Conclusions Based on the tapered-wedge design and proximal porous coating, the shortened tapered conventional stem can achieve reliable stability through neck filling and metaphyseal fixation, which does not depend on the isthmus hoop stress. This stem was suitable in severe osteoporotic patients with type C bones in young adults who presented with a correspondingly straightened femoral canal with a wide isthmus and thin cortex.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary total hip arthroplasty using a short bone-conserving stem in young adult osteoporotic patients with Dorr type C femoral bone

Peng¹,

Chang²,

Yue

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…To address this di cult issue, a case series was performed with many other choices of hip arthroplasty or other types of femur stems to address Dorr C osteoporotic bone in young adults [33,34]. Total hip resurfacing arthroplasty is a good alternative to conventional total hip arthroplasty and can provide excellent results in terms of implant survivorship after careful patient selection [42,43]. However, the poor bone mineral density may contribute to increased fractures of the femoral neck and head or pathological fractures in patients with severe osteoporosis, particularly in patients comorbid with rheumatologic disorders [44,45].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary Total hip Arthroplasty Using A Short Bone-Conserving Stem in Young Adult Osteoporotic Patients with Dorr type C Femoral Bone

Zhen

Chang

Yue

et al. 2020

Preprint

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Background: Dorr Type C femoral bone exhibits a wide, stovepipe-shaped femoral canal and thin cortices in the proximal femur. Dorr C bone combined with severe osteoporosis is an important challenge in primary hip arthroplasty. In this study, we assessed the effects of short metaphyseal fitting cementless stems on preformatted primary total hip arthroplasties in young adult osteoporotic patients with this femoral presentation.Methods: A total of 42 hip arthroplasties were performed in 35 young patients (range, 20 to 36 years) using a short Tri-lock bone preservation metaphyseal-fitting cementless femoral component between 2012 and 2017. The mean age at surgery of the 27 male (33 hips) and 8 female (9 hips) patients was 27.5 ± 3.7 years (range 20.3 to 35.8 years). The mean body mass index (BMI) was 20.2 kg/m2 (range, 16.8–23.2 kg/m2). According to Dorr’s criteria, all 42 femora were classified as type C bone and all femurs suffered from severe osteoporosis (Singh index≤3). Results: The mean follow-up period was 5.5 ± 1.1 years (range, 3.0–8.0 years). The clinical and functional results improved for the Harris hip score, WOMAC, and UCLA activity scores. The Harris Hip score improved from 48.0 ± 8.0 (range 38.0 to 61.0) preoperatively to 87.0 ± 9.0 (range 77.0 to 92.0) at 12 months after surgery and 91.0 ± 8.0 (range 85.0 to 98.0) at final follow-up. The preoperative UCLA activity score was 3.0±0.5 points (range, 1.0–4.0 points), which significantly improved to 7.5±0.7 points (range, 6.0–8.0 points) at the final follow-up. No patient exhibited thigh pain at the final follow-up. The mean stem-to-canal fill percentages were 97% ± 2.1% (anteroposterior view at midstem). For stem alignment, 40 hips (95.2%) of the femoral stem were positioned neutral to 3° of varus with reference to the femoral shaft axis. The remaining two were positioned at 4° varus to 4° valgus. Radiographic evaluation showed good osteointegration of the implants in follow-up.Conclusions: Based on the tapered-wedge design and proximal porous coating, the shortened tapered conventional stem can achieve reliable stability through neck filling and metaphyseal fixation, which does not depend on the isthmus hoop stress. This stem was suitable in severe osteoporotic patients with Type C bones in young adults who presented with a correspondingly straightened femoral canal with a wide isthmus and thin cortex.

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Hip Resurfacing Arthroplasty or Total Hip Arthroplasty?

Musbahi

Logishetty

Cobb

2021

Controversies in Orthopaedic Surgery of the Lower Limb

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Hip resurfacing arthroplasty for patients with inflammatory arthritis: a systematic review

Abstract: Femoral neck fracture was the most common reason for revision in patients with inflammatory arthritis following resurfacing and there were no dislocations reported. Following resurfacing, these patients have improved functional outcomes.

Cited by 8 publications

References 34 publications

Primary total hip arthroplasty using a short bone-conserving stem in young adult osteoporotic patients with Dorr type C femoral bone

Primary total hip arthroplasty using a short bone-conserving stem in young adult osteoporotic patients with Dorr type C femoral bone

Primary Total hip Arthroplasty Using A Short Bone-Conserving Stem in Young Adult Osteoporotic Patients with Dorr type C Femoral Bone

Hip Resurfacing Arthroplasty or Total Hip Arthroplasty?

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