TOTAL HIP ARTHROPLASTY WITH DOUBLE-TAPERED CEMENTLESS FEMORAL STEM FOR HIP BONY FUSION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Qiang , LIU Ming , CHAI Wei , ZHANG Guoqiang , CHEN Jiying , LI Zhongli , DONG Xiaoyan , ZHOU Yonggang , WANG Xiuli , WANG Yan.

Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China. Corresponding author: WANG Yan, E-mail: 301yanwang@gmail.com;

Corresponding author：

Keywords：

Total hip arthroplasty; Bony fusion; Double-tapered cementless femoral stem

DOI：

10.7507/1002-1892.20130064

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Objective To investigate the effectiveness of total hip arthroplasty with double-tapered cementless femoral stem for hip bony fusion by comparing with anatomical cementless femoral stem. Methods A retrospective analysis was made on clinical data of 50 cases (80 hips) of hip bony fusion undergoing total hip arthroplasty between October 1999 and January 2008. The patients were divided into 2 groups: 31 cases (49 hips) using BetaCone double-tapered cementless femoral stem (trial group), and 19 cases (31 hips) using Ribbed anatomical cementless femoral stem (control group). There was no significant difference in gender, age, disease duration, preoperative Harris score, and abduction angle of the hip between 2 groups (P gt; 0.05). After operation, X-ray films were used to calculate the ratio of force arm of abductor (a) to the force arm of gravity (b) and analyze the stability of the prosthesis. The abduction angle of the hip and Harris score were measured during follow-up. Results Fracture occurred during operation in 9 hips of 9 cases (5 in trial group and 4 in control group), and was cured after fixation. The mean follow-up time was 49 months (range, 12-98 months) in trial group and was 53 months (range, 6-105 months) in control group. The ratio of a/b was 0.65 ± 0.25 in trial group and was 0.56 ± 0.37 in control group, showing significant difference (t=2.19, P=0.03). The abduction angle of hip was (34.49 ± 7.58)° in trial group and was (30.97 ± 7.24)° in control group at 6 months after operation, which was significantly improved when compared with preoperative value in 2 groups (P lt; 0.05), and significant difference was found between 2 groups (t=2.06, P=0.04). Postoperative Harris score was significantly improved in 2 groups when compared with preoperative score (P lt; 0.05); trial group was better than control group in Harris score at 1 month after operation (t=3.62, P=0.01), but no significant difference was found between 2 groups at last follow-up (t=1.61, P=0.11). At last follow-up, X-ray films showed stabilized prosthesis in 2 groups. Grade I or II ectopic ossification occurred in 12 cases (14 hips) of trial group and 8 cases (9 hips) of control group at 2 years after operation. Conclusion The total hip arthroplasty with both double-tapered and anatomical cementless femoral stems for hip bony fusion can obtain satisfactory effectiveness, while the double-tapered cementless femoral stem has better abduction angle of hip.

Citation： ZHANG Qiang,LIU Ming,CHAI Wei,ZHANG Guoqiang,CHEN Jiying,LI Zhongli,DONG Xiaoyan,ZHOU Yonggang,WANG Xiuli,WANG Yan.. TOTAL HIP ARTHROPLASTY WITH DOUBLE-TAPERED CEMENTLESS FEMORAL STEM FOR HIP BONY FUSION. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(3): 278-282. doi: 10.7507/1002-1892.20130064 Copy

1.	Bhan S, Eachempati KK, Malhotra R. Primary cementless total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis. J Arthroplasty, 2008, 23(6): 859-866.
2.	Williams E, Taylor AR, Arden GP, et al. Arthroplasty of the hip in ankylosing spondylitis. J Bone Joint Surg (Br), 1977, 59-B(4): 393-397.
3.	Joshi AB, Markovic L, Hardinge K, et al. Total hip arthroplasty in ankylosing spondylitis: an analysis of 181 hips. J Arthroplasty, 2002, 17(4): 427-433.
4.	Sweeney S, Gupta R, Taylor G, et al. Total hip arthroplasty in ankylosing spondylitis: outcome in 340 patients. J Rheumatol, 2001, 28(8): 1862-1866.
5.	李明清, 胡懿郃, 李康华, 等. 保留股骨颈型人工全髋关节置换的中期疗效. 中国修复重建外科杂志, 2012, 26(8): 897-901.
6.	闵重函, 周瑛, 张洪美. 全髋关节置换术治疗非功能位髋关节骨性强直12例17髋. 中国骨伤, 2011, 24(3): 231-235.
7.	宋立明, 于建华, 张铁良. 人工全髋关节置换术治疗强直性脊柱炎髋关节屈曲强直的临床疗效. 中国修复重建外科杂志, 2009, 23(2): 205-208.
8.	Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141): 17-27.
9.	Johnston RC, Fitzgerald RH Jr, Harris WH, et al. Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg (Am), 1990, 72(2): 161-168.
10.	Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br), 1987, 69(1): 45-55.
11.	Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
12.	Idulhaq M, Park KS, Diwanji SR, et al. Total hip arthroplasty for treatment of fused hip with 90 degrees flexion deformity. J Arthroplasty, 2010, 25(3): 498. e5-498.e9.
13.	Kilgus DJ, Amstutz HC, Wolgin MA, et al. Joint replacement for ankylosed hips. J Bone Joint Surg (Am), 1990, 72(1): 45-54.
14.	Swanson MA, Huo MH. Total hip arthroplasty in the ankylosed hip. J Am Acad Orthop Surg, 2011, 19(12): 737-745.
15.	Bonin SJ, Eltoukhy MA, Hodge WA, et al. Conversion of fused hip to total hip arthroplasty with presurgical and postsurgical gait studies. J Arthroplasty, 2012, 27(3): 493. e9-493. e12.
16.	Dalury DF, Kelley TC, Adams MJ. Modern proximally tapered uncemented stems can be safely used in Dorr type C femoral bone. J Arthroplasty, 2012, 27(6): 1014-1018.
17.	Rhyu KH, Lee SM, Chun YS, et al. Does osteoporosis increase early subsidence of cementless double-tapered femoral stem in hip arthroplasty. J Arthroplasty, 2012, 27(7): 1305-1309.
18.	Costa CR, Johnson AJ, Mont MA. Use of cementless, tapered femoral stems in patients who have a mean age of 20 years. J Arthroplasty, 2012, 27(4): 497-502.
19.	Hwang BH, Lee WS, Park KK, et al. Straight tapered titanium stem with alumina bearing in cementless primary total hip arthroplasty: a minimum 5-year follow-up. J Arthroplasty, 2011, 26(8): 1310-1317.
20.	Scott RD, Sarokhan AJ, Dalziel R. Total hip and total knee arthroplasty in juvenile rheumatoid arthritis. Clin Orthop Relat Res, 1984, (182): 90-98.
21.	Bangjian H, Peijian T, Ju L. Bilateral synchronous total hip arthroplasty for ankylosed hips. Int Orthop, 2012, 36(4): 697-701.
22.	Kim YL, Shin SI, Nam KW, et al. Total hip arthroplasty for bilaterally ankylosed hips. J Arthroplasty, 2007, 22(7): 1037-1041.
23.	Kilgus DJ, Namba RS, Gorek JE, et al. Total hip replacement for patients who have ankylosing spondylitis. The importance of the formation of heterotopic bone and of the durability of fixation of cemented components. J Bone Joint Surg (Am), 1990, 72(6): 834-839.
24.	Walker LG, Sledge CB. Total hip arthroplasty in ankylosing spondylitis. Clin Orthop Relat Res, 1991, (262): 198-204.
25.	崔旭, 张伯勋, 李静东. 人工全髋关节置换术治疗56例强直性脊柱炎的临床研究. 中国矫形外科杂志, 2006, 14(9): 666-668.

1. Bhan S, Eachempati KK, Malhotra R. Primary cementless total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis. J Arthroplasty, 2008, 23(6): 859-866.
2. Williams E, Taylor AR, Arden GP, et al. Arthroplasty of the hip in ankylosing spondylitis. J Bone Joint Surg (Br), 1977, 59-B(4): 393-397.
3. Joshi AB, Markovic L, Hardinge K, et al. Total hip arthroplasty in ankylosing spondylitis: an analysis of 181 hips. J Arthroplasty, 2002, 17(4): 427-433.
4. Sweeney S, Gupta R, Taylor G, et al. Total hip arthroplasty in ankylosing spondylitis: outcome in 340 patients. J Rheumatol, 2001, 28(8): 1862-1866.
5. 李明清, 胡懿郃, 李康华, 等. 保留股骨颈型人工全髋关节置换的中期疗效. 中国修复重建外科杂志, 2012, 26(8): 897-901.
6. 闵重函, 周瑛, 张洪美. 全髋关节置换术治疗非功能位髋关节骨性强直12例17髋. 中国骨伤, 2011, 24(3): 231-235.
7. 宋立明, 于建华, 张铁良. 人工全髋关节置换术治疗强直性脊柱炎髋关节屈曲强直的临床疗效. 中国修复重建外科杂志, 2009, 23(2): 205-208.
8. Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141): 17-27.
9. Johnston RC, Fitzgerald RH Jr, Harris WH, et al. Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg (Am), 1990, 72(2): 161-168.
10. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br), 1987, 69(1): 45-55.
11. Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
12. Idulhaq M, Park KS, Diwanji SR, et al. Total hip arthroplasty for treatment of fused hip with 90 degrees flexion deformity. J Arthroplasty, 2010, 25(3): 498. e5-498.e9.
13. Kilgus DJ, Amstutz HC, Wolgin MA, et al. Joint replacement for ankylosed hips. J Bone Joint Surg (Am), 1990, 72(1): 45-54.
14. Swanson MA, Huo MH. Total hip arthroplasty in the ankylosed hip. J Am Acad Orthop Surg, 2011, 19(12): 737-745.
15. Bonin SJ, Eltoukhy MA, Hodge WA, et al. Conversion of fused hip to total hip arthroplasty with presurgical and postsurgical gait studies. J Arthroplasty, 2012, 27(3): 493. e9-493. e12.
16. Dalury DF, Kelley TC, Adams MJ. Modern proximally tapered uncemented stems can be safely used in Dorr type C femoral bone. J Arthroplasty, 2012, 27(6): 1014-1018.
17. Rhyu KH, Lee SM, Chun YS, et al. Does osteoporosis increase early subsidence of cementless double-tapered femoral stem in hip arthroplasty. J Arthroplasty, 2012, 27(7): 1305-1309.
18. Costa CR, Johnson AJ, Mont MA. Use of cementless, tapered femoral stems in patients who have a mean age of 20 years. J Arthroplasty, 2012, 27(4): 497-502.
19. Hwang BH, Lee WS, Park KK, et al. Straight tapered titanium stem with alumina bearing in cementless primary total hip arthroplasty: a minimum 5-year follow-up. J Arthroplasty, 2011, 26(8): 1310-1317.
20. Scott RD, Sarokhan AJ, Dalziel R. Total hip and total knee arthroplasty in juvenile rheumatoid arthritis. Clin Orthop Relat Res, 1984, (182): 90-98.
21. Bangjian H, Peijian T, Ju L. Bilateral synchronous total hip arthroplasty for ankylosed hips. Int Orthop, 2012, 36(4): 697-701.
22. Kim YL, Shin SI, Nam KW, et al. Total hip arthroplasty for bilaterally ankylosed hips. J Arthroplasty, 2007, 22(7): 1037-1041.
23. Kilgus DJ, Namba RS, Gorek JE, et al. Total hip replacement for patients who have ankylosing spondylitis. The importance of the formation of heterotopic bone and of the durability of fixation of cemented components. J Bone Joint Surg (Am), 1990, 72(6): 834-839.
24. Walker LG, Sledge CB. Total hip arthroplasty in ankylosing spondylitis. Clin Orthop Relat Res, 1991, (262): 198-204.
25. 崔旭, 张伯勋, 李静东. 人工全髋关节置换术治疗56例强直性脊柱炎的临床研究. 中国矫形外科杂志, 2006, 14(9): 666-668.

Chinese Journal of Reparative and Reconstructive Surgery

TOTAL HIP ARTHROPLASTY WITH DOUBLE-TAPERED CEMENTLESS FEMORAL STEM FOR HIP BONY FUSION

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