Basic ScienceComparison of Bone Remodeling Between an Anatomic Short Stem and a Straight Stem in 1-Stage Bilateral Total Hip Arthroplasty
Section snippets
Subjects
The study included 41 patients (6 men and 35 women; mean age at surgery, 51.7 years) who underwent 1-stage bilateral THA between 2004 and 2007. Cases with extreme differences in stage or severity of OA were excluded. OA severity was evaluated using radiographic grading of the Japanese Orthopaedic Association (JOA grade) [23] and Crowe group [24], and cases with differences of more than 1 grade based on either system were excluded, as were cases with a difference of more than 1.0 in preoperative
Results
Preoperative morphology of femur was assessed as follows. Bone types were classified according to Dorr et al [31]. Specifically, hip types A, B, and C were 8/10 (straight stem/anatomic stem), 28/26, and 0/0 (P = .868), respectively. Average flare indices for the straight stem and anatomic stem were 4.34 ± 0.70 and 4.37 ± 0.75, respectively (P = .517). Average neck anteversion for the straight stem was 21.6° ± 13.8° and that for the anatomic stem was 25.4° ± 14.2° (P = .069). We observed no
Discussion
Radiographic changes indicative of cancellous condensation, bone atrophy due to stress shielding, or cortical hypertrophy were evaluated by analyzing both Gruen's [33] and equal-interval zones in hips of patients who had undergone 1-stage bilateral THA with the anatomic short stem on one side and a conventional straight stem on the other. Gruen's zone analysis is often used in radiographic evaluation of periprosthetic changes. In it, zones are proportional to stem length, and the corresponding
Acknowledgments
We thank Drs. Yoshinori Asou and Sadao Morita for clinical support of this study. We also acknowledge the excellent contributions of Ms. Rie Kitano and our radiological technologists to the dual-energy X-ray absorptiometry analysis.
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.07.016.