Original Article
The Effect of Stem Alignment on Results of Total Hip Arthroplasty with a Cementless Tapered-Wedge Femoral Component

https://doi.org/10.1016/j.arth.2007.04.002Get rights and content

Abstract

We evaluated the significance of the stem alignment in 98 consecutive primary total hip arthroplasties with a cementless CLS component (Zimmer, Winterthur, Switzerland) after a mean follow-up period of 7.7 years (range, 5-11years) The patients were divided into 3 groups on the basis of stem alignment: neutral, 62 hips (63%); valgus, 20 hips (21%); and varus, 16 hips (16%). Clinical and radiographic results for the groups were compared. No significant clinical or radiographic differences were found between groups. There was no difference in the Harris hip scores and in the incidence of thigh pain between groups. For all hips, radiographs showed stable osseous fixation of the stem and the cup. A similar pattern of adaptive bone remodeling occurred in all 3 groups. Stem alignment of a tapered-wedge cementless femoral component does not compromise the clinical and radiographic results of total hip arthroplasty at a mean end point of 7.7 years.

Section snippets

Materials and Methods

We performed 106 consecutive primary THAs in 90 patients between May 1995 and December 2000. Of these, 5 patients (5 hips) died and 3 patients (3hips) were lost to follow-up monitoring; this left 82 patients (98 hips) as the subjects of our retrospective review. None of the 8 patients (6.7%) who died or were lost to follow-up monitoring had required revision of the implant.

The femoral components were a cementless CLSfemoral component (Zimmer, Winterthur, Switzerland). The CLS stem was a

Results

No femoral or acetabular component showed radiographic evidence of mechanical loosening during the course of this study, and no components had been revised as of the 5- to 11-year follow-up examination. No progression of the varus and valgus changes in component position was detected in any hip. Clinical and radiographic results were compared for the 3 groups.

There was no difference in the Harris hip scores (P=.59) and the incidence of thigh pain (P = .65) between the groups. The Harris hip

Discussion

This study shows that stem alignment of a tapered-wedge cementless CLS femoral component does not compromise clinical and radiographic results of THA at an average follow-up period of 7.7 years.

Currently, many different mini-incisions, or minimally invasive surgical approaches, are used for THA. The proposed advantages of mini-incision THA are reduced postoperative pain, faster rehabilitation, less blood loss, and less scarring. However, some researchers are concerned that mini-incision THA may

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    • Is a Total Hip Arthroplasty Stem in Varus a Risk Factor of Long-Term Mechanical Complication?

      2023, Journal of Arthroplasty
      Citation Excerpt :

      It would be interesting to assess our patients after the same time lapse to investigate whether new clinical or radiographic outcomes may come to light. According to many authors [18,22,36,38], varus positioning is not a risk factor for aseptic loosening, but implanting an undersized stem is. We did not assess implant size, but we report five cases of subsidence in the Varus Stem group, two between 5 and 10 mm and three of 10 mm or more, compared to one case between 5 and 10 mm in the Neutral Stem group.

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    No benefits or funds were received in support of the study.

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