Distribution and Outliers of Anteversion of Short-length Cementless Stem

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2021 Nov 20

PMID 34799778

Citations 5

Authors

Hong-Seok Kim

Young-Kyun Lee

Joo-Hyung Ha

Se Jin Park

Jung-Wee Park

Kyung-Hoi Koo

Affiliations

Soon will be listed here.

Abstract

Introduction: Inadequate stem version might lead to impingement and instability after cementless total hip arthroplasty (THA). We evaluated (1) the distribution of short-stem anteversion, (2) the proportion of stems with an anteversion less than 5° or larger than 25°, (3) combined cup and stem anteversion, and (4) dislocation rate.

Materials And Methods: We evaluated the native femoral anteversion and stem anteversion in 340 patients (340 THAs): 144 men and 196 women. Their mean age was 56.2 (22-87) years and mean body mass index was 25.1 (15.2-40.7) kg/m. The femoral neck anteversion was measured on pre-operative CT scan and the stem anteversion was obtained during the operation. The safe zone of the stem anteversion was defined as 5 to 25°.

Results: The femoral neck anteversion ranged from -15 to 61° (mean, 15.0°; SD, ±10.6°). The stem anteversion ranged -7 to 50° (mean, 15.7°; SD, ±9.5°). It was optimal (5-25°) in 71.2% (242/340), insufficient (<5°) in 13.3% (45/340), and excessive (>25°) in 15.6% (53/340). The stem anteversion had a medium correlation with the femoral neck anteversion (correlation coefficient = 0.449). The combined anteversion was 42.0° (range, 35.2-52.3°; SD, ±2.8°). During two to four year follow-up, no hip dislocated.

Conclusions: Short-length stem had a great variability in the anteversion and considerable portion (28.9%, 98/340) of stems had an anteversion outside the safe zone. Surgeons should be aware of this variability of stem anteversion to compensate for abnormal stem anteversion, which might lead to impingement and instability after THA.

Citing Articles

Femoral Neck Anteversion: Which Distal Femur Landmark Matters?.

Davis E, LeBrun D, McCarthy T, Westrich G Arthroplast Today. 2024; 26:101318.

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Improved radiographic outcomes and decreased complications rate on the femoral side can be achieved by a novel designed whole-process robotic assisted hip system for total hip arthroplasty: a prospective randomized controlled trial.

Huang Z, Zhang Z, Wang W, Wang G, Lu X, Zhang H J Robot Surg. 2024; 18(1):79.

PMID: 38365906 DOI: 10.1007/s11701-024-01835-8.

Effect of longer femoral head on leg length, offset, and range of motion in total hip arthroplasty: a simulation study.

Shimizu T, Miyazaki T, Yokota S, Ishizu H, Takahashi D, Iwasaki N Sci Rep. 2024; 14(1):1829.

PMID: 38246928 PMC: 10800334. DOI: 10.1038/s41598-024-52264-4.

Short-stem total hip arthroplasty is equivalent to a standard-length stem procedure in an unselected population at mid-term follow-up.

Barbier O, Rassat R, Caubere A, Dubreuil S, Estour G Int Orthop. 2023; 48(4):1017-1022.

PMID: 37934276 DOI: 10.1007/s00264-023-06020-4.

Achieving Target Cemented Femoral Stem Anteversion Using a 3-Dimensional Model.

Rebgetz P, McCarthy T, McLaren H, Wilson M, Whitehouse S, Crawford R Arthroplast Today. 2023; 19:101084.

PMID: 36688094 PMC: 9852927. DOI: 10.1016/j.artd.2022.101084.

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