ArticleInternational orthopaedics2020
Risk factors for subsidence of modular fluted tapered stem implanted by using transfemoral Wagner approach during revision hip arthroplasty.
Article in International orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 6 citations in OpenAlex.
- High subsidence rate in primary total hip arthroplasty with a taper wedge stem featuring a three-dimensionally printed porous structure.Archives of orthopaedic and trauma surgery · 2025Article
- Resection and reconstruction of the proximal femur with revision stems: a cost-effective alternative.Annals of joint · 2023Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo determine clinical and radiographic risk factors for the vertical subsidence of modular fluted tapered stems implanted using the transfemoral Wagner approach in a cohort of revision hip arthroplasties.
methodsA retrospective review of a single-centre surgical registry was performed. Patients who underwent a revision total hip arthroplasty, in which the uncemented modular fluted tapered stem (REVISION Hip/Anca-Ti6Al4V, LimaCorporate, Udine, Italy) was implanted using the transfemoral Wagner approach, were identified. Patient's demographic data, clinical and radiographic outcomes and post-operative complications were assessed. As a significant subsidence, a 5-mm cut-off was chosen.
resultsWe identified 278 revision hip arthroplasties with a mean follow-up of 35 months. The median of subsidence in the group of 5 mm and less was 2 mm, and 17 mm in the group of subsidence of 5 mm and more. A negative correlation was found between the stem subsidence and the length of good contact between the medial and lateral cortical bone and the stem (medial, - 0.248; P < 0.001, lateral, 0.284; P < 0.001). For 200 mm stems, the percentage of good contact between femoral parts of stem and bone on medial side was 40.5% (81.0 mm) for patients with subsidence of five or less mm, and 30% (60.0 mm) for lateral side. For 140 mm stems, the percentage was 52.86% (74.0 mm) for medial side and 40.36% (56.5 mm) for lateral side. A neck length was shown to correlate significantly with the stem subsidence (P = 0.004).
conclusionIt is crucial to provide good contact between the bilateral cortical bone and stem, and, if possible, to select implant constructs with shorter femoral necks, in order to reduce subsidence and to ensure longer implant survivorship.
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