Goksel Dikmen1, Vahit Emre Ozden2, Burak Beksac3, Ismail Remzi Tozun2. 1. Acibadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Orthopedics and Traumatology, Acibadem Maslak Hospital, Buyukdere Cad No 40 34457, Maslak, Istanbul, Turkey. gdkmen@yahoo.com. 2. Acibadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Orthopedics and Traumatology, Acibadem Maslak Hospital, Buyukdere Cad No 40 34457, Maslak, Istanbul, Turkey. 3. Department of Orthopedics and Traumatology, Acibadem Maslak Hospital, Buyukdere Cad No 40 34457, Maslak, Istanbul, Turkey.
Abstract
PURPOSE: The aim of this study was to assess the long-term performance of tapered one-third proximally coated stems in dysplastic hips. METHODS: This study included 135 dysplasia patients (150 hips) who underwent a total hip arthroplasty and had a minimum follow-up of ten years. Single design tapered stems were used in all patients. There were 112 women (83%) and 23 men (17%) with a mean age of 45 years (23 to 72) at the time of surgery. The mean follow-up was 14.7 years (10 to 16.8). For clinical evaluation, the Harris Hip Score and Merle D'Aubigne scale were used pre-operatively and at the final follow-up. Implant survival was calculated using Kaplan-Meier survivorship analysis, with failure defined as a component revision for any reason. RESULTS: Overall, one stem was revised for a deep infection. There were no other femoral stem revisions secondary to loosening, wear, periprosthetic fracture, or instability. Radiographic evaluation showed excellent stem osteointegration in all cases. Kaplan-Meier survivorship, with stem revision for any reason as the end point, was 98% at 14 years (95% confidence interval 92.5 to 99.8). CONCLUSION: This study demonstrates that a dual offset tapered stem achieved excellent survivorship and stability, as well as good clinical outcome scores with minimal thigh pain and stress shielding in patients with arthritis and developmental dysplasia of the hip; a dual offset tapered stem may be a suitable option for primary total hip arthroplasty in this group.
PURPOSE: The aim of this study was to assess the long-term performance of tapered one-third proximally coated stems in dysplastic hips. METHODS: This study included 135 dysplasiapatients (150 hips) who underwent a total hip arthroplasty and had a minimum follow-up of ten years. Single design tapered stems were used in all patients. There were 112 women (83%) and 23 men (17%) with a mean age of 45 years (23 to 72) at the time of surgery. The mean follow-up was 14.7 years (10 to 16.8). For clinical evaluation, the Harris Hip Score and Merle D'Aubigne scale were used pre-operatively and at the final follow-up. Implant survival was calculated using Kaplan-Meier survivorship analysis, with failure defined as a component revision for any reason. RESULTS: Overall, one stem was revised for a deep infection. There were no other femoral stem revisions secondary to loosening, wear, periprosthetic fracture, or instability. Radiographic evaluation showed excellent stem osteointegration in all cases. Kaplan-Meier survivorship, with stem revision for any reason as the end point, was 98% at 14 years (95% confidence interval 92.5 to 99.8). CONCLUSION: This study demonstrates that a dual offset tapered stem achieved excellent survivorship and stability, as well as good clinical outcome scores with minimal thigh pain and stress shielding in patients with arthritis and developmental dysplasia of the hip; a dual offset tapered stem may be a suitable option for primary total hip arthroplasty in this group.
Entities:
Keywords:
Dysplasia; Long-term outcome; Primary total hip arthroplasty; Tapered stem
Authors: Alberto Di Martino; Francesco Castagnini; Niccolò Stefanini; Barbara Bordini; Giuseppe Geraci; Federico Pilla; Francesco Traina; Cesare Faldini Journal: J Orthop Traumatol Date: 2021-07-18