ArticleInternational orthopaedics2018
High incidence of early subtrochanteric lateral cortical atrophy after hip arthroplasty using bone-conserving short stem.
Article in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Rotating hinge expandable prostheses may have a higher risk of medial tibial plateau deformity compared to constrained hinged expandable prostheses following reconstruction of distal femur in children with primary bone tumors.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Influence of the Acetabular Cup Material on the Shell Deformation and Strain Distribution in the Adjacent Bone-A Finite Element Analysis.Materials (Basel, Switzerland) · 2020Article
- Outcome of short versus conventional stem for total hip arthroplasty in the femur with a high cortical index: a five year follow-up prospective multicentre comparative study.International orthopaedics · 2020Article
- Incidence and pattern of periprosthetic hip fractures around the stem in different stem geometry.International orthopaedics · 2020Article
- Development of periprosthetic bone mass density around the cementless Metha® short hip stem during three year follow up-a prospective radiological and clinical study.International orthopaedics · 2019Article
- Fourteen-year experience with short cemented stems in total hip replacement.International orthopaedics · 2019Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeLoad transfer to the bone is believed to be more physiological around the short stem in total hip arthroplasty (THA). However, we found unusual bony remodeling around the shortened tapered stem. This study was performed to investigate the extent and frequency of this phenomenon and to find the possible risk factors of it.
methodsAmong 121 consecutive THA using the same short stem, 80 THAs were enrolled. Radiographic measurements were made using anteroposterior (AP) radiographs taken immediately and at two years after surgery. The thickness of the lateral cortex at the level of the distal end of the coated surface and at 10, 20, 30, and 40 mm proximal to it were measured.
resultsSignificant atrophy was noted in all regions (P < 0.001 each). In 46 cases, this presented as an intra-cortical osteolytic line (IOL). Sixty-one cases showed either an IOL or atrophy >10%. The risk of a mean reduction >20% was related to an increased operating time (odds ratio [OR] = 0.981; 0.966 < 95% confidence interval [CI] < 0.996) and lower body mass index (BMI) (OR = 1.216; 1.043 < 95% CI < 1.417). Periprosthetic fracture through the lateral cortex occurred in one case.
conclusionEven with THA using a shortened stem, high incidence of proximal stress shielding was noted in the form of lateral cortical atrophy, especially for the patient with low BMI.
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