Comparison of Anatomic Vs. Straight Femoral Stem Design in Total Hip Replacement - Femoral Canal Fill in Vivo

2016 ◽  
Vol 27 (3) ◽  
pp. 241-244 ◽  
Author(s):  
Friso A. de Boer ◽  
Elhadi Sariali
Keyword(s):  
Hip Replacement ◽  
Femoral Stem ◽  
X Rays ◽  
Femoral Canal ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Satisfactory Outcome ◽  
Central Level

Introduction The femoral canal fill between an anatomic and a straight prosthesis design in cementless total hip arthroplasty (THA) was compared. We hypothesised that the anatomic SPS stem has higher proximal fill and lesser distal fill than the straight stem. Material and methods The femoral canal fill was measured on 3 months routine postoperative x-rays at 5 levels of the stem in 50 consecutive patients, aged 35-83 years, who underwent 56 THA procedures by a single surgeon in this hospital. 22 patients received a straight design Ceramconcept Global stem, 34 patients received an anatomic design Symbios SPS stem. Both anteroposterior (AP) and lateral x-rays were combined to suggest a 3-D measurement. Results On the AP x-rays, the canal fill was significantly higher using the anatomic design stem at the proximal measurement levels, and was significantly higher at the distal levels using the straight stem. With the AP and lateral x-rays combined, the canal fill at the proximal levels was also significantly higher in the anatomic groups, nonsignificantly lower at the central level and significantly lower at the distal levels. Discussion In THA surgery, achieving high fill at the metaphysis of the femur and less fill at the diaphysis has been suggested to result in satisfactory outcome and high stability of the prosthesis. This study demonstrated that, compared to straight stem design, an anatomically designed stem has a significantly higher metaphyseal femoral canal fill.

Displacement of Femoral Stem during Closed Reduction of Total Hip Arthroplasty

1997 ◽  
Vol 7 (3) ◽  
pp. 125-127
Author(s):  
J. Cordes ◽  
K. Sperling ◽  
M. Kramhøft
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Femoral Stem ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Image Intensification

In the literature, only one case of displacement of a cemented femoral stem from its cement bed during closed reduction of a dislocation has been reported. In that case, it was suggested that the stem design may in part be the explanation for the displacement. Another case with a cemented Müller straight stem is now presented, emphasizing the use of image intensification if reduction proves difficult.

scholarly journals Biomechanical evaluation of a new femoral stem design for total hip replacement in a canine model

2021 ◽  
Vol 36 (5) ◽  
Author(s):  
Luís Guilherme de Faria ◽  
Bruno Watanabe Minto ◽  
Antonio Carlos Shimano ◽  
Ana Paula Macedo ◽  
Lucia Maria Izique Diogo ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Canine Model ◽  
Stem Design ◽  
Total Hip ◽  
Biomechanical Evaluation

scholarly journals Short-stem total hip arthroplasty is not associated with an earlier return to work compared to a straight-stem design

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Georg Hauer ◽  
Maria Smolle ◽  
Sabrina Zaussinger ◽  
Joerg Friesenbichler ◽  
Andreas Leithner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Sick Leave ◽  
Return To Work ◽  
Hip Arthroplasty ◽  
Short Stem ◽  
Multivariate Linear Regression Analysis ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Significant Difference

AbstractReturn to work (RTW) has been specifically identified as a high priority in patients undergoing total hip arthroplasty (THA). This investigation sought to assess the effect of the stem design on patients’ RTW. Secondly, the study aimed to identify risk factors that lead to a delayed RTW. Questionnaires inquiring about RTW, employment history, educational level, type of work, physical demands and joint awareness were administered by post. Further data were collected from patients’ hospital records. 176 patients who underwent THA using a short-stem and 97 patients using a straight-stem design were compared. The median return to work time was 10 weeks [IQR 7–14 weeks], with no significant difference between the two groups (short stems vs. straight stems; 10 [IQR 7–14] vs. 11 [7.5–13.5] weeks; p = 0.693). In the multivariate linear regression analysis, self-employment vs. employee (p = 0.001), dimension of preoperative workload (p = 0.001), preoperative sick leave (p < 0.001), and hospital length of stay (LOS) (p < 0.001) independently affected the period until work was resumed. The Forgotten-Joint-Score-12 showed no significant difference between the two groups. The data show that the majority of THA patients can expect to resume work and stem design has no impact on RTW. Employees with preoperative sick leave, prolonged hospital LOS and low workload are at higher risk for a delayed RTW.

The effects of age and gender on the diameter of the femoral canal in patients who undergo total hip replacement

2013 ◽  
Vol 95-B (3) ◽  
pp. 339-342 ◽  
Author(s):  
D. J. Milligan ◽  
S. O’Brien ◽  
D. Bennett ◽  
J. C. Hill ◽  
D. E. Beverland
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Canal ◽  
Age And Gender ◽  
Total Hip ◽  
And Gender

Variation in femoral anteversion in patients requiring total hip replacement

2019 ◽  
Vol 30 (3) ◽  
pp. 281-287
Author(s):  
Jim W Pierrepont ◽  
Ed Marel ◽  
Jonathan V Baré ◽  
Leonard R Walter ◽  
Catherine Z Stambouzou ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Femoral Anteversion ◽  
Patient Specific ◽  
3 Dimensional ◽  
Total Hip ◽  
Age Related ◽  
Gender And Age ◽  
Implant Alignment

Background: Optimal implant alignment is important for total hip replacement (THR) longevity. Femoral stem anteversion is influenced by the native femoral anteversion. Knowing a patient’s femoral morphology is therefore important when planning optimal THR alignment. We investigated variation in femoral anteversion across a patient population requiring THR. Methods: Preoperatively, native femoral neck anteversion was measured from 3-dimensional CT reconstructions in 1215 patients. Results: The median femoral anteversion was 14.4° (−27.1–54.5°, IQR 7.4–20.9°). There were significant gender differences (males 12.7°, females 16.0°; p < 0.0001). Femoral anteversion in males decreased significantly with increasing age. 14% of patients had extreme anteversion (<0° or >30°). Conclusions: This is the largest series investigating native femoral anteversion in a THR population. Patient variation was large and was similar to published findings of a non-THR population. Gender and age-related differences were observed. Native femoral anteversion is patient-specific and should be considered when planning THR.

Complications and radiographic findings following cemented total hip replacement

2006 ◽  
Vol 19 (03) ◽  
pp. 172-179 ◽  
Author(s):  
R. S. Gilley ◽  
F. S. Shofer ◽  
A. S. Kapatkin ◽  
M. S. Bergh
Keyword(s):  
Total Hip Replacement ◽  
Revision Surgery ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Short Term ◽  
Radiographic Appearance ◽  
Radiographic Findings ◽  
Total Hip ◽  
Technical Errors ◽  
Radiographic Changes

SummaryCemented total hip replacement (cTHR) is commonly performed to treat intractable coxofemoral pain in dogs. While owners generally perceive a good outcome after the procedure, the longevity of the implant may be limited by complications such as infection and aseptic loosening. The objective of this retrospective study was to identify the prevalence of complications and radiographic changes following cTHR, and to identify factors that may predispose to a need for revision surgery. Medical records and radiographs from 97 dogs that underwent cTHR were evaluated for signalment, preoperative degree of osteoarthritis, technical errors, intra-operative culture results, and the post-operative radiographic appearance of the implant. The complications occurring in the intra-operative and short-term (<eight week) periods, and the radiographic appearance of the implant in the long-term (>eight week) time period were recorded. Mean (±SD) follow-up time was 1.1 ± 1.6 years (range: 0–7.7 years). Seven dogs had a short-term complication and a revision surgery was performed in eleven dogs. Osseous or cement changes were radiographically detectable in the majority of cTHR. Eccentric positioning of the femoral stem and the presence of radiolucent lines at the femoral cement-bone interface were positively associated with the occurrence of revision surgery. The clinical significance of the periprosthetic radiographic changes is unclear and further investigation is warranted.

Modification of Pelvic Orientation after Total Hip Replacement in Primary Osteoarthritis

2009 ◽  
Vol 19 (3) ◽  
pp. 257-263 ◽  
Author(s):  
Elhadi Sariali ◽  
Jean Yves Lazennec ◽  
Frederic Khiami ◽  
Michel Gorin ◽  
Yves Catonne
Keyword(s):  
Healthy Volunteers ◽  
Range Of Motion ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Sacral Slope ◽  
X Rays ◽  
Acetabular Anteversion ◽  
Total Hip ◽  
Pelvic Inclination ◽  
Primary Osteoarthritis

The acetabular anteversion angle varies according to the position of the pelvis. The objective goal of our study was to investigate changes in pelvic orientation after total hip replacement for primary osteoarthritis. We studied 89 patients who underwent total hip replacement for primary unilateral osteoarthritis. Lateral pelvic X-rays that included the hips were performed pre-operatively and one year post-operatively. Reference values were calculated by carrying out the same analysis in 100 asymptomatic healthy volunteers. Pelvic orientation was analyzed using the sacral slope. Patients having surgery for osteoarthritis had a decreased pelvic range of motion pre-operatively and post-operatively when compared to healthy volunteers. Post-operatively, this range of motion increased by 3° but remained lower than the norm. Compared to asymptomatic healthy volunteers, patients affected by osteoarthritis had a posterior pelvic extension that decreased post-operatively but did not return to norm. This post-operative pelvic inclination generates a significant decrease in the final cup anteversion and thus may predispose to posterior dislocation. As this post-operative alteration to pelvic orientation cannot be anticipated, computer-aided surgery for cup positioning may not improve the accuracy of the acetabular anteversion in some patients.

Short-Term Clinical Assessment of Hip Hemi-Arthroplasty in 11 Dogs

2021 ◽  
Author(s):  
Renée Huggard ◽  
Grace Wicks ◽  
Gordon Corfield
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Salvage Procedure ◽  
Short Term ◽  
Total Hip ◽  
Pelvic Radiography ◽  
Hemi Arthroplasty

Abstract Objective The aim of this study was to assess the short-term clinical outcome in dogs following a hip hemi-arthroplasty for the treatment of primary pathological disorders of the hip and as a salvage procedure following failure of the cup component of a total hip replacement. Materials and Methods Medical records of dogs that had a unilateral hip hemi-arthroplasty performed between 2015 and 2020 were reviewed. Data collected included follow-up orthopaedic examinations performed at 0, 2, 8 and 52 weeks postoperatively, pelvic radiography at 0, 8 and 52 weeks postoperatively and an owner questionnaire (Helsinki chronic pain index [HCPI]). Results Eleven unilateral hip hemi-arthroplasty procedures were identified. The median age at time of surgery was 3.6 years (8 months–10 years) and the median follow-up time was 13 months (range: 2 months–3 years). The HCPI for all dogs at follow-up was median 8 ± 7.30 (range: 5–25). Total HCPI was < 12 for 7/10 dogs and ≥ 12 for 3 dogs. Pelvic radiographs at 1 year confirmed osteointergration of the femoral stem implant and no evidence of implant subsidence or progression of osteoarthritis. However, there was some evidence of mild lucency of the acetabular bed around the prosthetic femoral head and mild peri-acetabular sclerosis in four cases. Conclusion Hip hemi-arthroplasty provides a clinically acceptable treatment for disabling disease of the coxofemoral joint with 10/11 patients achieving acceptable short-term clinical function. Long-term assessment of the hip hemi-arthroplasty and comparison with total hip replacement is indicated.

Systematic Review of Radiological Analysis of Total Hip Replacement via Direct Anterior Approach in Comparison to Other Approaches – Study Protocol

2020 ◽  
Author(s):  
Bartosz Maciąg ◽  
Kuba Radzimowski ◽  
Piotr Stępiński ◽  
Jakub Szymczak ◽  
Tomasz Albrewczyński ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Hip Replacement ◽  
Anterior Approach ◽  
Femoral Stem ◽  
Direct Anterior Approach ◽  
Controlled Trials ◽  
Total Hip ◽  
Randomized Controlled ◽  
Radiological Analysis

Abstract Background Total hip arthroplasty (THR) is considered as the most effective available method of treatment of end-stage hip osteoarthritis (OA). This surgery can be performed via many different approaches. One of the newly developed technique is called direct anterior approach (DAA). It gains popularity and recognition as the least traumatic to the soft tissues, thus quickening rehabilitation and improving joint stability in the early postoperative period. There are no systematic reviews covering this subject in terms of potential differences in radiological prosthesis placement, and while there is still unsatisfactory evidence concerning long-term outcomes of DAA, such review may prove useful in the debate. The objective of our study was to systematically collect and review available data from randomized-controlled trials (RCTs) regarding radiographic assessment of prosthesis placement after total hip arthroplasty using direct anterior approach compared to other common approaches.Methods A systematic review of randomized controlled trials (RCTs) will be conducted. SciFinder, Scopus, ScienceDirect, PubMed, Embase, Clinical Key and The Cochrane Library databases will be searched without restriction to date up to June 2020. Primary outcomes will include measurements related with the radiological analysis of trials comparing use of DAA to other approaches used for THR, containing at least two of the following: femoral stem alignment, mean radiographic cup inclination, mean radiographic cup anteversion, mean radiographic cup abduction, position in Lewinnek's safe zone. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological appraisal of the studies will be assessed by the Cochrane Risk-of-Bias Tool for RCTs. Discussion This systematic review will provide missing information regarding influence of differences between DAA and other surgical approaches in total hip replacement on prosthesis implants placement in case of femoral stem and cup. This may result in improving knowledge and awareness of surgeons, improving patients satisfaction and functional outcome and lowering the risk of hip dislocations and other complications. Trial registration International Registration of Systematic reviews (PROSPERO) number CRD42019122675

Centralization of the Femoral Component in THR. Biomechanical Considerations and Method

1993 ◽  
Vol 3 (2) ◽  
pp. 33-38
Author(s):  
G. Krakovits ◽  
L. Sass
Keyword(s):  
Femoral Component ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Canal ◽  
Internal Wall ◽  
Operative Method ◽  
Total Hip ◽  
Anatomical Axis

The correct implacement of the femoral component is decisive in the longevity of the total hip replacement (THR). The stem has to be placed along the anatomical axis of the femur and accomodated to the internal wall of the femoral canal to prevent tilting, subsidence, torsion movement and its clinical disadvantages. The author discusses the biomechanical consideration as well as the operative method.

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