Level of osteotomy is relevant to obtain better union and clinical results in patients with severe hip dysplasia operated on with total hip arthroplasty and shortening osteotomy using a cementless, rectangular femoral component

Kayaalp, Mahmut Enes; Can, Ata; Erdoğan, Fahri; Özşahin, Mahmut Kürşat; Aydıngöz, Önder; Kaynak, Gökhan

doi:10.1007/s00402-020-03659-1

Cited by 2 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Introductionmentioning

confidence: 99%

“…[2,6] Rectangular implants bear the advantage of less intramedullary bone removal and early inherent implant stability with four-point rotational stability. [7] On the other hand, round, double tapered, and fluted stems were also shown to provide excellent clinical and radiological results, [3] although a former study documented high-grade stress shielding on long-term follow-up in a dysplastic coxarthrosis cohort. [8] In the present study, we aimed to examine whether clinical or radiological results favored one of the femoral components, either rectangular (SL-Plus ® , Smith&Nephew, Memphis, TN) or round (Synergy ® , Smith&Nephew, Memphis, TN) stem in Crowe type 2 or 3 dysplastic hips operated on with THA without a shortening osteotomy.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The round femoral stem provides a similar clinical outcome but more serious proximal stress shielding compared to the rectangular stem in cementless total hip arthroplasty without a shortening osteotomy in patients with Crowe type 2 or 3 hip dysplasia

Kayaalp¹,

Erdoğan

Kaynak

2022

Jt Dis Relat Surg

Self Cite

View full text Add to dashboard Cite

Objectives This study aims to compare clinical and radiological follow-up results of a rectangular (SL-Plus®) or a round (Synergy®) femoral component in patients with Crowe type 2 or 3 hip dysplasia operated with total hip arthroplasty (THA) without a shortening osteotomy. Patients and methods Between January 2012 and December 2017, a total of 34 hips of 30 female patients (mean age: 42.9±11.6 years; range, 24 to 66 years) were retrospectively analyzed. All patients were evaluated using the Harris Hip Score (HHS) and Visual Analog Scale (VAS) for pain pre- and postoperatively. Intra- and postoperative complications were noted. Evaluation criteria included leg length discrepancy, stem subsidence, bone atrophy or hypertrophy around the stem according to Gruen zones, operative time, and intraoperative blood loss. Correlation analysis of radiological, clinical findings, and stem size was performed. Results The mean follow-up was 61.3±27.2 months. The mean postoperative HHS was 89.3±6.2 vs. 93.1±9.1, and the mean VAS score 1±0.6 vs. 1±0.8 in round and rectangular stem groups at the final follow-up. No significant differences were detected between the groups in any of the evaluated parameters, except for a more severe degree of stress shielding observed in the round stem group. Round stem size was positively correlated with a more severe stress shielding (r=0.55, p=0.020). No patient had to be revised during the follow-up period. The overall complication rate was 9%. Conclusion Successful and comparable results can be obtained with cementless THA in patients with high riding dysplastic hips implanting either of the femoral components, a rectangular or a round stem. Although the round stem was associated with more common proximal stress shielding, this was not associated with worse clinical outcomes.

show abstract