Leiss, Franziska and Goetz, Julia Sabrina and Meyer, Matthias and Maderbacher, Gunther and Reinhard, Jan and Parik, Lukas and Grifka, Joachim and Greimel, Felix (2022) Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 142 (4). pp. 673-680. ISSN 0936-8051, 1434-3916
Full text not available from this repository. (Request a copy)Abstract
Background Femoral component subsidence is a known risk factor for early failure of total hip arthroplasty (THA) using cementless stems. The aim of the study was to compare an enhanced recovery concept with early full weight-bearing rehabilitation and partial weight-bearing on stem subsidence. In addition, the influence of patient-related and anatomical risk factors on subsidence shall be assessed. Methods One hundred and fourteen patients underwent primary cementless THA and were retrospectively analyzed. Sixty-three patients had an enhanced recovery rehabilitation with early full weight-bearing and 51 patients had rehabilitation with partial weight-bearing (20 kg) for 6 weeks. Postoperative subsidence was analyzed on standing pelvic anterior-posterior radiographs after 4 weeks and 1 year. Subsidence was measured in mm. Anatomical and prosthetic risk factors (stem size, canal flare index, canal fill ratio as well as BMI and demographic data) were correlated. Results Femoral stem subsidence rate was significantly higher for the group with an enhanced recovery concept compared to the group with partial weight-bearing at the first radiological follow up after 4 weeks [2.54 mm (SD +/- 1.86) vs. 1.55 mm (SD +/- 1.80)] and the second radiological follow up after 1 year [3.43 mm (SD +/- 2.24) vs. 1.94 (SD +/- 2.16)] (p < 0.001, respectively). Stem angulation > 3 degrees had a significant influence on subsidence. Canal flare index and canal fill ratio showed no significant correlation with subsidence as well as BMI and age. Conclusion In the present study, cementless stem subsidence was significantly higher in the group with enhanced recovery rehabilitation compared to partial weight-bearing. Small absolute values and differences were demonstrated and therefore possibly below clinical relevance. Anatomical radiological parameters and anthropometric data did not appear to be risk factors for stem subsidence.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TOTAL HIP-ARTHROPLASTY; FOLLOW-UP; IMPLANTS; MOTION; MICROMOTION; PROSTHESES; FIXATION; TITANIUM; 10-YEAR; METAL; Stem subsidence; Total hip arthroplasty; Cementless THA; Enhanced recovery; Weight-bearing |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Sep 2022 11:42 |
| Last Modified: | 12 Sep 2022 11:42 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47182 |
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