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The objective of this study is to compare the long-term survival as well as the functional and radiographic results of the rods in the alignment of the varus to the stems in the neutral alignment by comparing 2 groups of implanted Total Hip Arthroplasty. 1 group of stems implanted in varus position. 1 group of stems implanted in neutral position
ABSTRACT:
Introduction: Femoral stem positioning in the frontal plane has always been considered a fundamental criterion for implant survival and for functional and radiographic outcomes in total hip arthroplasty (THA). The impact of implanting cementless femoral stems in varus alignment on long-term mechanical complications remains poorly defined in the literature. The aim of our study is to compare long-term survivorship as well as functional and radiographic outcomes of stems in varus alignment to stems in neutral alignment.
Patients and Methods: This single center, multi-surgeon, retrospective case-control study will compare a group of 105 THA patients with varus stem alignment (VS) to a control group of 105 THA patients with neutral stem alignment (NS), operated in Brest center between January 2007 and December 2012. The primary outcome measure is implant survival. Secondary outcomes include functional outcomes: HHS, PMA, thigh pain, dislocation and hip ROM; and radiographic outcomes: radiolucency, Agora Roentgenography Assessment (ARA) score, osseointegration, heterotopic ossification, subsidence and stress shielding.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Varus Stems | Patients with a THA Stem implanted in Varus position |
| |
| Neutral stems | Patients with a THA Stem implanted in Neutral position |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Total Hip Arthroplasty | Procedure | Patient were operated, a Total hip arthroplasty was performed |
|
| Measure | Description | Time Frame |
|---|---|---|
| Survival rate | The main outcome measured was the survival of the implant | It was measured in October 2021 |
| Measure | Description | Time Frame |
|---|---|---|
| HHS | Functional outcome : - The Harris Hip Score (HHS) [26] which assesses pain, function, deformity and range of motion (ROM) with a maximum score of 100 | It was measured in October 2021 |
| PMA score : |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who received a first-line PTH between 2007 and 2012,
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| Name | Affiliation | Role |
|---|---|---|
| Hoel Letissier, MD | CHU de Brest | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Brest | Brest | 29609 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30289882 | Result | Batailler C, Fary C, Servien E, Lustig S. Influence of femoral broach shape on stem alignment using anterior approach for total hip arthroplasty: A radiologic comparative study of 3 different stems. PLoS One. 2018 Oct 5;13(10):e0204591. doi: 10.1371/journal.pone.0204591. eCollection 2018. | |
| 27768218 | Result | Murphy CG, Bonnin MP, Desbiolles AH, Carrillon Y, Asmall yi, Ukrainiant Si Selmi T. Varus will have varus; a radiological study to assess and predict varus stem placement in uncemented femoral stems. Hip Int. 2016 Nov 10;26(6):554-560. doi: 10.5301/hipint.5000412. Epub 2016 Oct 15. |
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| ID | Term |
|---|---|
| D019644 | Arthroplasty, Replacement, Hip |
| ID | Term |
|---|---|
| D019643 | Arthroplasty, Replacement |
| D001178 | Arthroplasty |
| D019637 | Orthopedic Procedures |
| D013514 | Surgical Procedures, Operative |
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Functional outcome : which assesses pain, gait and mobility with a maximum score of 18
| It was measured in October 2021 |
| Thigh pain | Functional outcome : we measured the rate of patients experiencing pain at the level of the thigh | It was measured in October 2021 |
| Dislocation | Functional outcome : hip disclocation rate over the follow up period | It was measured in October 2021 |
| Hip ROM | Functional outcome : Hip range of motion in flexion, adduction, extension, abduction and rotations | It was measured in October 2021 |
| Radiolucency | Radiographic outcome : - Radiolucency according to the Gruen/Callaghan zones | It was measured in October 2021 |
| Agora Roentgenography Assessment (ARA) score | Radiographic outcome : - Agora Roentgenography Assessment (ARA) score for cementless femoral stem stability according to Epinette | It was measured in October 2021 |
| Osseointegration | Radiographic outcome mesured was described in "Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components" Engh CA, Massin P, Suthers KE" | It was measured in October 2021 |
| Heterotopic ossification | Radiographic outcome : - Brooker classification of heterotopic ossification | t was measured in October 2021 |
| Subsidence | Radiographic outcome : - Subsidence: considered significant if more than 5 mm between the immediate postoperative x-ray and the last follow-up x-ray. Subsidence was assessed by measuring the distance between the tip of the trochanter and the "shoulder" of the stem | t was measured in October 2021 |
| Stress shielding. | Radiographic outcome : we measured the rate of patients with Xray showing stress shielding signs | t was measured in October 2021 |
| 30005422 | Result | Fottner A, Woiczinski M, Kistler M, Schroder C, Schmidutz TF, Jansson V, Schmidutz F. Varus malalignment of cementless hip stems provides sufficient primary stability but highly increases distal strain distribution. Clin Biomech (Bristol). 2018 Oct;58:14-20. doi: 10.1016/j.clinbiomech.2018.07.006. Epub 2018 Jul 5. |
| D019651 | Plastic Surgery Procedures |
| D019919 | Prosthesis Implantation |