Influence of proximal femoral morphology on osteointegration of the AMIS uncemented femoral stem in modern hip arthroplasty.

IF 2.3 4区 医学 Q2 ORTHOPEDICS
Maxime Maton, Emile Vandromme, Tatiana Charles, Bilal Kapanci, Marc Jayankura
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引用次数: 0

Abstract

Background: Indications for total hip arthroplasty (THA) have evolved over recent decades, with a growing trend toward operating on younger and more active patients. With this shift in patient demographics, there has been a change in femoral stem designs and proximal femoral morphology encountered. This study aimed to evaluate the potential correlation between femoral stem osteointegration and proximal femoral morphology using the Dorr and Noble classifications.

Materials and methods: We conducted a retrospective review of 122 uncemented femoral stems (AMIstem Medacta, triple tapered). The demographic data analyzed included sex, age, stem size, and surgical indications. Preoperative radiographs were reviewed to determine the Dorr classification as well as the canal-to-calcar isthmus ratio, cortical index, and canal flare index. Postoperative radiographs were carefully reviewed to identify the presence of potential postoperative radiolucencies. Inter- and intra-observer agreements for these parameters were also analyzed.

Results: Significant radiolucencies (> 2 mm) were found in 19.5% of the patients. Of all the variables analyzed, the cortical index was the only parameter significantly associated with the appearance of clinically significant radiolucency, with a threshold value of 0.62.

Conclusions: The appearance of radiolucencies is multi-factorial. Nevertheless, in this study, a high cortical index (> 0.62), representing the champagne flute morphology, was found to be associated with the development of significant radiolucencies.

股骨近端形态对现代髋关节置换术中 AMIS 非骨水泥股骨柄骨整合的影响
背景:近几十年来,全髋关节置换术(THA)的适应症发生了变化,越来越倾向于为更年轻、更活跃的患者进行手术。随着患者人口结构的变化,股骨干设计和股骨近端形态也发生了变化。本研究旨在使用Dorr和Noble分类法评估股骨柄骨整合与股骨近端形态之间的潜在相关性:我们对122例非骨水泥股骨柄(AMIstem Medacta,三锥形)进行了回顾性研究。分析的人口统计学数据包括性别、年龄、柄大小和手术适应症。对术前X光片进行了审查,以确定Dorr分类以及骨管与髋臼峡部比率、皮质指数和骨管外翻指数。仔细检查术后X光片,以确定是否存在潜在的术后放射影。同时还分析了这些参数的观察者之间和观察者内部的一致性:结果:19.5%的患者发现了明显的放射状突起(> 2 毫米)。在所有分析的变量中,皮质指数是唯一一个与临床上出现的明显放射状透明显著相关的参数,阈值为 0.62:放射状白斑的出现是多因素的。然而,本研究发现,代表香槟笛形态的高皮质指数(> 0.62)与出现明显的放射斑痕有关。
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来源期刊
Arthroplasty
Arthroplasty ORTHOPEDICS-
CiteScore
2.20
自引率
0.00%
发文量
49
审稿时长
15 weeks
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