The effects of patient characteristics and stem alignment on distal femoral cortical hypertrophy after cemented polished tapered stem implantation
| Autor: | Toshiki Iwase, Genta Takemoto, Daigo Morita |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Cortical hypertrophy Male Reoperation medicine.medical_specialty Visual analogue scale Arthroplasty Replacement Hip Patient characteristics Kaplan-Meier Estimate Logistic regression Prosthesis Design 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Humans Orthopedics and Sports Medicine Clinical significance In patient 030212 general & internal medicine Femur Patient Reported Outcome Measures Pain Measurement 030222 orthopedics business.industry Incidence (epidemiology) Incidence Body Weight Bone Cements Odds ratio Hypertrophy Middle Aged Prognosis Surgery Prosthesis Failure Radiography Female Hip Prosthesis business |
| Zdroj: | European journal of orthopaedic surgerytraumatology : orthopedie traumatologie. 30(4) |
| ISSN: | 1432-1068 |
| Popis: | The objective of this study was to evaluate the results of over 10 years of total hip arthroplasty (THA) practice with ExeterTM stems and the clinical relevance of distal femoral cortical hypertrophy (DFCH). We retrospectively reviewed 127 hips (120 patients) that had undergone THA with ExeterTM stems between 2004 and 2007. Kaplan–Meier survival analyses for the stem of all 127 hips were performed using different endpoints. Of 127 hips, 100 (94 patients) had complete 10-year follow-up data, including the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) as the patient-reported outcomes, and the clinical relevance of DFCH was analyzed using multivariable logistic regression analysis. The survival of the stem with the endpoint of re-operation for loosening, > 5-mm subsidence, and re-operation for any reason were 100%, 99.1% (95% CI 97.5–100%), and 98.3% (95% CI 96.0–100%), respectively. Of 100 hips followed completely for 10 years, DFCH occurred in 20 hips (20%). The satisfaction and pain visual analog scale of JHEQ revealed high satisfaction and less pain in patients with DFCH. By multivariate logistic regression analysis, body weight > 55 kg (odds ratio: 2.88, p = 0.035) and varus stem alignment (odds ratio: 6.56, p = 0.003) were found to be predictors for DFCH. The incidence of DFCH with the ExeterTM stem was 20%. A body weight > 55 kg and varus stem alignment are predictors for future DFCH. DFCH with the ExeterTM stem indicates a good outcome with less hip pain. |
| Databáze: | OpenAIRE |
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