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Eur J Orthop Surg Traumatol. 2018 Dec;28(8):1625-1632. doi: 10.1007/s00590-018-2227-6. Epub 2018 Jun 27.

The effect of flexion alignment in total hip arthroplasty with a cementless tapered-wedge femoral stem.

Author information

1
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa Prefecture, 920-8641, Japan.
2
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa Prefecture, 920-8641, Japan. tamonkabata@yahoo.co.jp.

Abstract

INTRODUCTION:

The influence of stem sagittal alignment on clinical outcomes is unclear in total hip arthroplasty (THA). The purpose of this study is to assess the relationship between stem sagittal alignment and clinical and radiographic outcomes using 3D-CT.

MATERIALS AND METHODS:

We performed 370 consecutive primary THAs between 2009 and 2013. After exclusion, 102 hips in 89 patients using single tapered-wedge stem were included. Mean follow-up was 4.7 years. Stem sagittal alignment was measured using CT, and patients were divided into flexion and neutral alignment groups. Clinical and radiographic outcomes were compared between two groups. Furthermore, we evaluated the anterior femoral offset and initial contact state.

RESULTS:

There were no significant differences in clinical or radiographic outcomes between two groups. CT data analysis and multiple regression analysis showed flexion alignment increased anterior femoral offset (AFO) and Gruen zone 4 contact area.

CONCLUSIONS:

There was no significant difference in clinical or radiographic outcomes between flexion and neutral alignment of the tapered-wedge stem at an average of 4.7 years of follow-up. The increase of AFO and distal contact area in flexion alignment could affect the improvement of impingement-free range of flexion and intraoperative fracture.

KEYWORDS:

Anterior femoral offset; Sagittal alignment; Tapered-wedge stem; Total hip arthroplasty

PMID:
29951745
DOI:
10.1007/s00590-018-2227-6

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