Masanori Fujii1, Kenji Kitamura2, Satoshi Ikemura2, Satoshi Hamai2, Goro Motomura2, Yasuharu Nakashima2. 1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi. Higashi-ku, Fukuoka, 812-8582, Japan. m-fujii@ortho.med.kyushu-u.ac.jp. 2. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi. Higashi-ku, Fukuoka, 812-8582, Japan.
Abstract
PURPOSE: Stem subsidence is a known cause of early failure in cementless total hip arthroplasty (THA). The aim of this study was to determine the usefulness of pneumatic femoral broaching in preventing post-operative subsidence of a proximally porous-coated, taper-wedge stem. METHODS: We reviewed 169 cases of primary THA with a single taper-wedge stem. Eighty THAs performed using pneumatic broaching were compared with 89 THAs performed using manual broaching in terms of postoperative canal fill ratio (CFR) at three levels, stem subsidence at one year post-operation, and stem fixation at latest follow-up (median, 24 months). RESULTS: The median CFRs were higher in the pneumatic group than in the manual group at all levels (p < 0.05). The median stem subsidence at one year after THA was lower in the pneumatic group than in the manual group (0.2 mm vs. 0.6 mm, p = 0.007). A multivariate analysis determined a decreased CFR at 60 mm below the lesser trochanter and the manual broaching as independent factors affecting post-operative stem subsidence. At the latest follow-up, all stems showed stable fixation by bone ingrowth in both groups. CONCLUSION: Our results showed that the pneumatic broaching device was useful in maximizing the mediolateral canal filling and initial stability and minimizing the subsidence of taper-wedge stems.
PURPOSE: Stem subsidence is a known cause of early failure in cementless total hip arthroplasty (THA). The aim of this study was to determine the usefulness of pneumatic femoral broaching in preventing post-operative subsidence of a proximally porous-coated, taper-wedge stem. METHODS: We reviewed 169 cases of primary THA with a single taper-wedge stem. Eighty THAs performed using pneumatic broaching were compared with 89 THAs performed using manual broaching in terms of postoperative canal fill ratio (CFR) at three levels, stem subsidence at one year post-operation, and stem fixation at latest follow-up (median, 24 months). RESULTS: The median CFRs were higher in the pneumatic group than in the manual group at all levels (p < 0.05). The median stem subsidence at one year after THA was lower in the pneumatic group than in the manual group (0.2 mm vs. 0.6 mm, p = 0.007). A multivariate analysis determined a decreased CFR at 60 mm below the lesser trochanter and the manual broaching as independent factors affecting post-operative stem subsidence. At the latest follow-up, all stems showed stable fixation by bone ingrowth in both groups. CONCLUSION: Our results showed that the pneumatic broaching device was useful in maximizing the mediolateral canal filling and initial stability and minimizing the subsidence of taper-wedge stems.
Authors: Lucian C Warth; Tanner W Grant; Neal B Naveen; Evan R Deckard; Mary Ziemba-Davis; R Michael Meneghini Journal: J Arthroplasty Date: 2020-02-17 Impact factor: 4.757
Authors: Tanner W Grant; Luke R Lovro; David J Licini; Lucian C Warth; Mary Ziemba-Davis; Robert M Meneghini Journal: J Arthroplasty Date: 2016-09-28 Impact factor: 4.757
Authors: Marcus R Streit; Burkhard Lehner; David S Peitgen; Moritz M Innmann; Georg W Omlor; Tilman Walker; Christian Merle; Babak Moradi Journal: Clin Orthop Relat Res Date: 2020-06 Impact factor: 4.755