Cementless total hip arthroplasty with anatomic-shaped implants. Does the minimal invasive anterolateral technique influence the stem position or subsidence in contrast to the standard lateral approach?
Alignment
Anterolateral approach
Collared
Minimally invasive hip arthroplasty
Subsidence
WOMAC
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
24
10
2020
accepted:
09
08
2021
pubmed:
15
8
2021
medline:
19
8
2022
entrez:
14
8
2021
Statut:
ppublish
Résumé
Using cementless stems in total hip arthroplasty (THA) has revealed variable results. The risk for early aseptic loosening has been associated to certain surgical approaches and implant designs. This study determines misalignment of collared/collarless stems and the rate of subsidence using the anterolateral approach (ALA) compared to implantations via the direct lateral approach (DLA). One hundred consecutive patients underwent primary unilateral THA using the minimal invasive ALA in the lateral decubitus position and were compared to another cohort of 100 patients, treated trough the DLA. Clinical results were noted preoperatively and after 1 year using the WOMAC score. The radiographic evaluation included the stem alignment and subsidence. Overall, all patients improved in WOMAC from 48.9 points (± 11.4; 21.0-82.0) to 3.1 (± 3.2; 0.0-22.0) (p < 0.001). For DLA and ALA, the stem was placed on average 2.5° in varus to the femoral axis. The mean alignment was about 0.5° more valgus for collarless stems. The mean subsidence in the DLA group was about 0.3 mm higher compared to the ALA group. With collarless implants, the subsidence was about 1.0 mm higher compared to collared implants (p < 0.05), especially in patients with Dorr type B femurs. Changing from the DLA to the minimal invasive ALA did not significantly affect the implant position. Misalignment and a potential risk for early aseptic loosening could not be seen. The use of a collared cementless stem seems safe and is likely to prevent a relevant subsidence, even more so in Dorr type B femurs. III.
Identifiants
pubmed: 34390388
doi: 10.1007/s00402-021-04122-5
pii: 10.1007/s00402-021-04122-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2389-2395Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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