Varus stem positioning does not affect long-term functional outcome in cementless anatomical total hip arthroplasty.
Anatomical stem
Survivorship
Total hip arthroplasty
Varus alignment
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:
Jan 2023
Jan 2023
Historique:
received:
20
04
2021
accepted:
14
12
2021
pubmed:
7
1
2022
medline:
2
2
2023
entrez:
6
1
2022
Statut:
ppublish
Résumé
Varus positioning is the most common femoral malposition in total hip arthroplasty (THA). We compared the long-term outcomes of an anatomical cementless femoral stem positioned in varus versus neutral alignment. Data were retrospectively reviewed for all patients receiving a cementless anatomical femoral stem in THA for osteoarthritis between 1998 and 2008. Exclusion criteria were complex cases, incomplete data or follow-up < 1 year. Primary outcome was survival rate with complications and secondary outcomes were clinical scores, thigh pain, radiological score, cortical hypertrophy and filling rate. Of the 283 included patients, 127 stems were classified as varus and 156 neutral. Mean follow-up was 10 years. Femoral stem size was smaller in the varus group (4.1 vs. 4.4, p = 0.047). A stem-filling rate < 80% was more frequent in the varus group (p < 0.001). The long-term survival rate without any revision procedure was 94.8% ± 2.3% (95%CI 88.4-98.7) in the varus group and 94.1% ± 2.0% (95%CI 91.3-99.1) in the neutral group (p = 0.55). There was no difference in clinical scores, thigh pain or complication occurrence between groups. The Engh-Massin score was lower in the varus group (p < 0.01) and cortical hypertrophy was higher (p < 0.001). A varus alignment of a cementless anatomic femoral stem does not affect survivorship, clinical outcomes or complication rate on an average follow-up of 10 years, despite increasing stress-shielding rates.
Identifiants
pubmed: 34989837
doi: 10.1007/s00402-021-04320-1
pii: 10.1007/s00402-021-04320-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
511-518Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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