The correlation between clinical radiological outcome and contact state of implant and femur using three-dimensional templating software in cementless total hip arthroplasty

被引：24
作者：
Inoue D. [1 ]
Kabata T. [1 ]
Maeda T. [1 ]
Kajino Y. [1 ]
Yamamoto T. [1 ]
Takagi T. [1 ]
Ohmori T. [1 ]
Tsuchiya H. [1 ]
机构：
[1] Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Ishikawa
来源：
European Journal of Orthopaedic Surgery & Traumatology | 2016年 / 26卷 / 6期
基金：
日本学术振兴会;
关键词：
Density mapping; Radiological outcome; Three-dimensional templating software; Total hip arthroplasty;
D O I：
10.1007/s00590-016-1796-5
中图分类号：
学科分类号：
摘要：
Background: Initial fixation is a key factor in the success of cementless THA using a tapered wedge stem. The purpose of this study was to use three-dimensional templating software to examine the correlation between quantitative contact state and important clinical radiological outcomes, specifically stem subsidence, stress shielding, and cortical hypertrophy. Methods: We conducted a retrospective consecutive review of 75 hips in 70 patients over a minimum 3-year follow-up period. X-rays and CT scans were investigated to assess preoperative planning, quantify the contact state of implant and femur, and assess stem alignment, stem subsidence, stress shielding, and cortical hypertrophy. We evaluated the correlation between radiological outcomes and three-dimensional quantitative contact state according to Gruen Zone in each Dorr classification. Results: Density mapping indicated that stem subsidence increased postoperatively if the stem had less cortical contact in the middle to distal portion of the implant in terms of initial fixation. Cases having too much cortical contact in the distal portion of the implant tended to have increased stress shielding. We found no correlation between cortical hypertrophy and the contact state of implant and femur. Conclusions: Density mapping with three-dimensional templating software can be useful in predicting stem subsidence and stress shielding following cementless THA with a tapered wedge stem. Further analysis is required to accurately depict the correlation between cortical hypertrophy and the contact state. © 2016, Springer-Verlag France.
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页码：591 / 598
页数：7
相关论文
共 25 条
  • [1] Devane P.A., Wraighte P.J., Ong D.C.G., Horne J.G., Do joint registries report true rates of hip dislocation?, Clin Orthop Relat Res, 470, 11, pp. 3003-3006, (2012)
  • [2] McLaughlin J.R., Lee K.R., Total hip arthroplasty with an uncemented tapered femoral component, J Bone Joint Surg Am, 90, 6, pp. 1290-1296, (2008)
  • [3] Teloken M.A., Bissett G., Hozack W.J., Sharkey P.F., Rothman R.H., Ten to fifteen-year follow-up after total hip arthroplasty with a tapered cobalt-chromium femoral component (tri-lock) inserted without cement, J Bone Joint Surg Am, 84-A, 12, pp. 2140-2144, (2002)
  • [4] Purtill J.J., Rothman R.H., Hozack W.J., Sharkey P.F., Total hip arthroplasty using two different cementless tapered stems, Clin Orthop Relat Res, 393, pp. 121-127, (2001)
  • [5] White C.A., Carsen S., Rasuli K., Feibel R.J., Kim P.R., Beaule P.E., High incidence of migration with poor initial fixation of the accolade stem, Clin Orthop Relat Res, 470, 2, pp. 410-417, (2012)
  • [6] Khanuja H.S., Vakil J.J., Goddard M.S., Mont M.A., Cementless femoral fixation in total hip arthroplasty, J Bone Joint Surg Am, 93, 5, pp. 500-509, (2011)
  • [7] Haraguchi K., Sugano N., Nishii T., Koyama T., Nishihara S., Yoshikawa H., Ochi T., Comparison of fit and fill between anatomic stem and straight tapered stem using virtual implantation on the ORTHODOC workstation, Comput Aided Surg, 6, 5, pp. 290-296, (2001)
  • [8] Nishihara S., Sugano N., Nishii T., Tanaka H., Yoshikawa H., Ochi A., Comparison of the fit and fill between the Anatomic Hip femoral component and the Versys Taper femoral component using virtual implantation on the ORTHODOC workstation, J Orthop Sci, 8, 3, pp. 352-360, (2003)
  • [9] Inoue D., Kabata T., Maeda T., Kajino Y., Fujita K., Hasegawa K., Yamamoto T., Takagi T., Ohmori T., Tsuchiya H., Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty, Eur J Orthop Surg Traumatol, 25, 8, pp. 1293-1300, (2015)
  • [10] Crowe J.F., Mani V.J., Ranawat C.S., Total hip replacement in congenital dislocation and dysplasia of the hip, J Bone Joint Surg Am, 61, 1, pp. 15-23, (1979)
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