Cementless Total Hip Arthroplasty Using Dual Offset Titanium Tapered Stem: At Least 7-Year Follow-Up / 대한정형외과학회잡지

PURPOSE: The purpose of current study is to evaluate the midterm results of cementless primary total hip arthroplasty (THA) using a dual offset titanium tapered stem. MATERIALS AND METHODS: A retrospective analysis of 102 cases (84 patients), with a minimum of 7-year clinical follow-up, was performed. All of the cases consisted of patients who underwent primary cementless THA, using a dual offset titanium tapered stem in The Catholic University of Korea, Bucheon St. Mary's Hospital between July 2004 and May 2009. Clinical results were analyzed via the Harris hip score, level of thigh pain, squeaking around hip joint, and complication rate. Radiologic results were examined with stability and location of inserted prosthesis, hypertrophy of femoral cortex, and osteolysis. RESULTS: Out of the 102 cases (84 patients; 47 males and 37 females), with the mean age of 55.9 years (range, 27–79 years) and mean follow-up period of 99.2 months (range, 84–132 months). The mean Harris hip score was 53.8 preoperatively (range, 26–75) and improved to 93.5 postoperatively (range, 74–100) (p=0.000). All of the cases gained stable bony fixation on the final follow-up, including 2 cases of intra-operative proximal femur fracture. Calcar remodeling was observed in 94 cases, however, they were irrelevant with stem stability. Cortical hypertrophy of femur was seen in 12 cases and thigh pain in 4 cases; nonetheless, they were not relevant (p=0.067). There was 1 case of squeaking sound during joint movement. Hip dislocation occurred in 1 case early after the procedure, but the event was due to excessive anteversion of the acetabular cup, in which a revisional replacement procedure of the acetabular cup was conducted. No sign of ceramic breakage was observed. There were 2 cases of heterotrophic ossification. CONCLUSION: Results from a 7-year follow-up of cementless THA using dual offset titanium tapered stem were encouraging in both clinical and radiologic evaluations.

Cementless Total Hip Arthroplasty Using a Tapered Femoral Component / 대한정형외과학회잡지

PURPOSE: We investigated the results of cementless total hip arthroplasty using a tapered titanium-alloy stem. MATERIALS AND METHODS: We followed 72 hips in 60 patients who underwent total hip arthroplasty and received the using Mallory-Head femoral component for a mean of 9.1 years. The most common disease was avascular necrosis (56 hips; 77.7%). Their mean age was 50.1 years at the time operation. We analysed the clinical results by the Merle d'Aubigne and Postel scoring system and the radiographic outcome according to Engh's criteria. RESULTS: The mean hip score was 16.4 at the last followup. An excellent or good clinical result was obtained in 62 hips (86.1%). Thigh pain was present in 3 hips (4.1%), and femoral osteolysis was observed in 8 hips (11.1%), which did not progress to the distal part. Two femoral components were revised for loosening and for periprosthetic fracture. Thus, 69 stems survived at the last follow up. Sixty-six hips (91.7%) had fixation by bone ingrowth, and three (4.1%) showed stable fibrous fixation. CONCLUSION: These results shows that excellent fixation can be obtained by using a tapered titanium alloy femoral component by medium-term followup.