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Age-Associated Changes in Proximal Femur Morphology Affect Femoral Component Sizing in Cementless Hip Arthroplasty

Overview
Publisher Sage Publications
Specialty Geriatrics
Date 2022 Dec 15
PMID 36519004
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Abstract

Background: In cementless hip arthroplasty, the femoral component should obtain firm fixation within the endosteal bone and achieve adequate reconstruction of hip joint biomechanics simultaneously. Previous anatomical studies described age-related changes of the proximal femoral canal, such as canal widening, which theoretically necessitates the use of larger stem sizes in elderly patients. This study examines a potential association between patients' age at surgery and the implant size of a cementless femoral component.

Material And Methods: A total of 13,423 primary hip arthroplasties with a single cementless stem registered in the Dutch Arthroplasty Register (LROI) were included. Patient characteristics (ie patients' age, sex, height and weight at time of surgery) and femoral component size were derived. A one-way ANCOVA was used to compare the mean stem size between age groups, and multivariable linear regression analysis was used in order to investigate to which extent ageing impacted stem size.

Results: Each subsequent age- group (ten-year intervals) had a significantly larger mean stem size than the prior age- group. Multivariable linear regression analysis revealed that age is positively correlated with stem size and that this correlation is more prominent in females than in males (beta = .046, P < .001 and beta = .028, P < .001 respectively).

Interpretation: Implant size is positively correlated with age, in particular in females and independently from investigated anthropometric characteristics. The present study endorses that the femoral canal morphology is related to patients' characteristics such as age and sex. The morphology will subsequently influence implant sizing and therefore may have biomechanical and clinical implications.

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No proportional relationship between shape and size of the femoral canal and the external proximal femur morphology in elderly patients.

Veldman H, Heyligers I, Boymans T J Orthop. 2025; 67:118-125.

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Radiological Comparison of Canal Fill between Collared and Non-Collared Femoral Stems: A Two-Year Follow-Up after Total Hip Arthroplasty.

Ashkenazi I, Benady A, Ben Zaken S, Factor S, Abadi M, Shichman I J Imaging. 2024; 10(5).

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References
1.
Tsai T, Dimitriou D, Li G, Kwon Y . Does total hip arthroplasty restore native hip anatomy? three-dimensional reconstruction analysis. Int Orthop. 2014; 38(8):1577-83. PMC: 4115107. DOI: 10.1007/s00264-014-2401-3. View

2.
Vresilovic E, Hozack W, Rothman R . Incidence of thigh pain after uncemented total hip arthroplasty as a function of femoral stem size. J Arthroplasty. 1996; 11(3):304-11. DOI: 10.1016/s0883-5403(96)80083-0. View

3.
Wegrzyn J, Roux J, Loriau C, Bonin N, Pibarot V . The tridimensional geometry of the proximal femur should determine the design of cementless femoral stem in total hip arthroplasty. Int Orthop. 2018; 42(10):2329-2334. DOI: 10.1007/s00264-018-3843-9. View

4.
Morris K, Davies H, Wronka K . Implant-related complications following hip hemiarthroplasty: a comparison of modern cemented and uncemented prostheses. Eur J Orthop Surg Traumatol. 2015; 25(7):1161-4. DOI: 10.1007/s00590-015-1671-9. View

5.
Boymans T, Heyligers I, Grimm B . The Morphology of the Proximal Femoral Canal Continues to Change in the Very Elderly: Implications for Total Hip Arthroplasty. J Arthroplasty. 2015; 30(12):2328-32. DOI: 10.1016/j.arth.2015.06.020. View