John M Dundon1, Dvorah Leah Felberbaum2, William J Long2. 1. Orthopedic Institute of New Jersey, 108 Bilby Rd, Suite 210, Hackettstown, NJ 07840, United States. 2. NYU Langone Medical Center, Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA.
Abstract
BACKGROUND: Total hip arthroplasty (THA) is a highly successful surgery with a high prevalence in women. Women have been noted to have smaller proximal femoral anatomy and decreased bone strength compared to males. The goal of our study was to define the size discrepancy in femoral stem implants between men and women using a metaphyseal fitting single taper stem. METHODS: We retrospectively reviewed the THA's performed by a single surgeon over the previous two years. Data was extracted from operative reports regarding stem size, neck length and offset, and conversion to a different type of stem. This data was reviewed with confidence intervals and a t-test was performed for independent samples with a p < 0.05 being determined significant. RESULTS: We analyzed the data from 276 THA's performed (129 in men, and 147 in women). Women were noted to be associated with smaller stem sizes compared to men (37.67% in women, 6.11% in men), with 7.48% of women requiring conversion to a different type of implant. There was a significant difference in mean stem size (9.21 in men, 6.70 in women, p < 0.0001). Women also required reduced neck options significantly more often than men (38.97% in women, 9.29% in men, p < 0.0001). CONCLUSION: Review of femoral stem sizes reveals that current femoral stem sizing may not appropriately account for women and alternative stem options should be available if using a metaphyseal fitting single tapered stems. Future consideration should be given to more anatomic female sized femoral stems or alternative options should be available.
BACKGROUND: Total hip arthroplasty (THA) is a highly successful surgery with a high prevalence in women. Women have been noted to have smaller proximal femoral anatomy and decreased bone strength compared to males. The goal of our study was to define the size discrepancy in femoral stem implants between men and women using a metaphyseal fitting single taper stem. METHODS: We retrospectively reviewed the THA's performed by a single surgeon over the previous two years. Data was extracted from operative reports regarding stem size, neck length and offset, and conversion to a different type of stem. This data was reviewed with confidence intervals and a t-test was performed for independent samples with a p < 0.05 being determined significant. RESULTS: We analyzed the data from 276 THA's performed (129 in men, and 147 in women). Women were noted to be associated with smaller stem sizes compared to men (37.67% in women, 6.11% in men), with 7.48% of women requiring conversion to a different type of implant. There was a significant difference in mean stem size (9.21 in men, 6.70 in women, p < 0.0001). Women also required reduced neck options significantly more often than men (38.97% in women, 9.29% in men, p < 0.0001). CONCLUSION: Review of femoral stem sizes reveals that current femoral stem sizing may not appropriately account for women and alternative stem options should be available if using a metaphyseal fitting single tapered stems. Future consideration should be given to more anatomic female sized femoral stems or alternative options should be available.
Entities:
Keywords:
Femoral sizing; Periprosthetic fracture; Total hip arhtroplasty; Women
Authors: Hilal Maradit Kremers; Dirk R Larson; Cynthia S Crowson; Walter K Kremers; Raynard E Washington; Claudia A Steiner; William A Jiranek; Daniel J Berry Journal: J Bone Joint Surg Am Date: 2015-09-02 Impact factor: 5.284
Authors: W Högler; C J R Blimkie; C T Cowell; D Inglis; F Rauch; A F Kemp; P Wiebe; C S Duncan; N Farpour-Lambert; H J Woodhead Journal: Bone Date: 2008-01-26 Impact factor: 4.398