Comparison of Cylindrical and Tapered Stem Designs for Femoral Revision Hip Arthroplasty
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Assessment
2.2. Radiological Analysis
2.3. Statistical Analysis
3. Results
3.1. Clinical Results
3.2. Radiographic Results
3.3. Survival Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Demographic Data | Cylindrical Stems (N = 38) | Tapered Stems (N = 40) |
---|---|---|
Age (Years) | 68.55 ± 12.78 | 71.38 ± 12.86 |
Gender (Male/Female) | 21/17 | 21/19 |
Side (Right/Left) | 15/23 | 15/25 |
BMI 1 (kg/m2) | 26.54 ± 5.21 | 26.93 ± 4.97 |
Stature (cm) | 164.68 ± 6.73 | 167.33 ± 5.22 |
Smokers (%) | 28.9% | 17.24% |
Presence of DM (%) | 10.5% | 24.1% |
Heart failure (%) | 18.42% | 20.7% |
CKD 2 (%) | 21.1% | 10.3% |
Immunodeficiency (%) | 2.6% | 5.2% |
Reasons of revision (n) | ||
Aseptic loosening | 31 | 20 |
Infection | 5 | 5 |
Periprosthetic fracture | 2 | 6 |
Osteosynthesis failure | 0 | 5 |
Recurrent dislocation | 0 | 1 |
Two-stage revision (n) | 2 | 3 |
Pre-surgical HHS Jr 3 | 47.4 ± 15.3 | 49.3 ± 13.9 |
Paprosky femoral defect (n) | ||
Type I | 5 | 0 |
Type II | 21 | 20 |
Type IIIA | 11 | 18 |
Type IIIB | 1 | 2 |
Acetabular revision (%) | 42.1% | 62.1% |
Bone graft use (%) | 42.1% | 48.3% |
Femoral osteotomy (n) | ||
Not needed | 19 | 27 |
Trochanteric | 8 | 2 |
ETO 4 | 11 | 11 |
Lengths of the Stem Used (n) | |
---|---|
FCTS group (n = 40) | |
190 mm | 2 (5%) |
225 mm | 11 (27.5%) |
265 mm | 15 (37.5%) |
305 mm | 11 (27.5%) |
345 mm | 1 (2.5%) |
CCS group (n = 38) | |
203 mm | 17 (44.7%) |
254 mm | 21 (55.3%) |
Clinical Results | CNCCS (N = 38) | TNTS (N = 40) | Signification |
---|---|---|---|
Length of stay | 19.9 ± 2.1 | 21.5 ± 2.1 | p = 0.586 |
Blood loss (g/dL) | 4.7 ± 1.5 | 4.4 ± 1.1 | p = 0.459 |
Bone grafting (n) | 16 (42.1%) | 19 (47.5%) | p = 0.632 |
Need for ETO (n) | 11 (28.9%) | 11 (27.5%) | p = 0.840 |
2-stage revision (n) | 2 (5.3%) | 3 (7.5%) | p = 0.687 |
Intraoperative periprosthetic fracture (n) | 6 (15.7%) | 8 (20%) | p = 0.535 |
Post-op complications (n) | p = 0.658 | ||
Dislocation | 3 (7.9%) | 3 (7.5%) | |
Infection | 1 (2.6%) | 3 (7.5%) | |
Periprosthetic fracture | 0 | 1 (2.5%) | |
New loosening | 3 (7.9%) | 3 (7.5%) | |
Patient satisfaction (n) | p = 0.247 | ||
Unsatisfied | 6 | 11 | |
Fairly satisfied | 12 | 7 | |
Completely satisfied | 20 | 21 |
Radiolucencies by Gruen Zones at a Year of Follow-Up (n) | CNCCS (n = 38) | TNTS (n = 40) | Signification |
---|---|---|---|
Zone 1 | 14 | 5 | p = 0.012 * |
Zone 2 | 4 | 2 | p = 0.360 |
Zone 3 | 5 | 1 | p = 0.077 |
Zone 4 | 5 | 1 | p = 0.077 |
Zone 5 | 5 | 1 | p = 0.077 |
Zone 6 | 3 | 2 | p = 0.602 |
Zone 7 | 10 | 3 | p = 0.026 * |
Zone 8 | 7 | 3 | p = 0.149 |
Zone 9 | 4 | 1 | p = 0.149 |
Zone 10 | 6 | 1 | p = 0.040 * |
Zone 11 | 3 | 1 | p = 0.280 |
Zone 12 | 3 | 1 | p = 0.280 |
Zone 13 | 4 | 2 | p = 0.360 |
Zone 14 | 13 | 4 | p = 0.010 * |
Radiolucencies by Gruen Zones at the End of Follow-Up (n) | CNCCS (n = 38) | TNTS (n = 40) | Signification |
---|---|---|---|
Zone 1 | 15 | 7 | p = 0.042 * |
Zone 2 | 6 | 5 | p = 0.744 |
Zone 3 | 6 | 3 | p = 0.286 |
Zone 4 | 5 | 2 | p = 0.233 |
Zone 5 | 6 | 2 | p = 0.134 |
Zone 6 | 4 | 3 | p = 0.691 |
Zone 7 | 12 | 4 | p = 0.024 * |
Zone 8 | 9 | 4 | p = 0.127 |
Zone 9 | 7 | 2 | p = 0.075 |
Zone 10 | 7 | 1 | p = 0.025 * |
Zone 11 | 4 | 1 | p = 0.165 |
Zone 12 | 3 | 2 | p = 0.643 |
Zone 13 | 4 | 5 | p = 0.722 |
Zone 14 | 15 | 6 | p = 0.020 * |
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Hernández-Mateo, J.M.; Orozco-Martínez, J.; Matas-Díaz, J.A.; Vaquero, F.J.; Sanz-Ruiz, P. Comparison of Cylindrical and Tapered Stem Designs for Femoral Revision Hip Arthroplasty. J. Clin. Med. 2024, 13, 1745. https://doi.org/10.3390/jcm13061745
Hernández-Mateo JM, Orozco-Martínez J, Matas-Díaz JA, Vaquero FJ, Sanz-Ruiz P. Comparison of Cylindrical and Tapered Stem Designs for Femoral Revision Hip Arthroplasty. Journal of Clinical Medicine. 2024; 13(6):1745. https://doi.org/10.3390/jcm13061745
Chicago/Turabian StyleHernández-Mateo, José María, Javier Orozco-Martínez, José Antonio Matas-Díaz, Francisco Javier Vaquero, and Pablo Sanz-Ruiz. 2024. "Comparison of Cylindrical and Tapered Stem Designs for Femoral Revision Hip Arthroplasty" Journal of Clinical Medicine 13, no. 6: 1745. https://doi.org/10.3390/jcm13061745
APA StyleHernández-Mateo, J. M., Orozco-Martínez, J., Matas-Díaz, J. A., Vaquero, F. J., & Sanz-Ruiz, P. (2024). Comparison of Cylindrical and Tapered Stem Designs for Femoral Revision Hip Arthroplasty. Journal of Clinical Medicine, 13(6), 1745. https://doi.org/10.3390/jcm13061745