Cargando…

Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases

Background: Total hip arthroplasty (THA) affects the biomechanics of the hip and the patient gait. The stem design influences femoral lever ratios and tissue trauma. Biomechanical changes such as these have the potential to induce knee arthritis. A varus or valgus configuration of knee arthritis is...

Descripción completa

Detalles Bibliográficos
Autores principales: Thöne, Paul, Gruber, Michael Stephan, Kindermann, Harald, Gussner, Walter, Sadoghi, Patrick, Ortmaier, Reinhold
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607773/
https://www.ncbi.nlm.nih.gov/pubmed/37892800
http://dx.doi.org/10.3390/jcm12206662
_version_ 1785127622058967040
author Thöne, Paul
Gruber, Michael Stephan
Kindermann, Harald
Gussner, Walter
Sadoghi, Patrick
Ortmaier, Reinhold
author_facet Thöne, Paul
Gruber, Michael Stephan
Kindermann, Harald
Gussner, Walter
Sadoghi, Patrick
Ortmaier, Reinhold
author_sort Thöne, Paul
collection PubMed
description Background: Total hip arthroplasty (THA) affects the biomechanics of the hip and the patient gait. The stem design influences femoral lever ratios and tissue trauma. Biomechanical changes such as these have the potential to induce knee arthritis. A varus or valgus configuration of knee arthritis is formed by asymmetric loadings. The aim of this study was to evaluate the impact of stem design in THA on knee valgus by comparing a standard implant with an implant with a short stem. Methods: A total of 2953 patients who underwent primary total knee arthroplasty for end-stage osteoarthritis between 2015 and 2021 were included in this retrospective data analysis. Patients were divided into three groups, depending on hip status (straight stem, short stem, and native joint). Leg alignment was distinguished as varus or valgus, and the degree of axial deviation was measured. Descriptive and explorative statistical analyses were performed, with a p value < 0.05 set as significant. Results: Ipsilateral knee valgus occurred significantly more often in patients with straight stems (57.2%) than in those with short stems (29%) and native joints (25.8%) (p < 0.001). Additionally, mean valgus deviation was significantly increased in patients with straight stems (8.9°) compared to those with short stems (6.4°) or native hip joints (6.7°). Both findings were accentuated in women. Conclusions: Previous ipsilateral straight-stem THA is associated with knee valgus deformity, especially in women. Short-stem THA seems to be better suited to restoring physiological biomechanics and preventing the development of valgus osteoarthritis of the ipsilateral knee.
format Online
Article
Text
id pubmed-10607773
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-106077732023-10-28 Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases Thöne, Paul Gruber, Michael Stephan Kindermann, Harald Gussner, Walter Sadoghi, Patrick Ortmaier, Reinhold J Clin Med Article Background: Total hip arthroplasty (THA) affects the biomechanics of the hip and the patient gait. The stem design influences femoral lever ratios and tissue trauma. Biomechanical changes such as these have the potential to induce knee arthritis. A varus or valgus configuration of knee arthritis is formed by asymmetric loadings. The aim of this study was to evaluate the impact of stem design in THA on knee valgus by comparing a standard implant with an implant with a short stem. Methods: A total of 2953 patients who underwent primary total knee arthroplasty for end-stage osteoarthritis between 2015 and 2021 were included in this retrospective data analysis. Patients were divided into three groups, depending on hip status (straight stem, short stem, and native joint). Leg alignment was distinguished as varus or valgus, and the degree of axial deviation was measured. Descriptive and explorative statistical analyses were performed, with a p value < 0.05 set as significant. Results: Ipsilateral knee valgus occurred significantly more often in patients with straight stems (57.2%) than in those with short stems (29%) and native joints (25.8%) (p < 0.001). Additionally, mean valgus deviation was significantly increased in patients with straight stems (8.9°) compared to those with short stems (6.4°) or native hip joints (6.7°). Both findings were accentuated in women. Conclusions: Previous ipsilateral straight-stem THA is associated with knee valgus deformity, especially in women. Short-stem THA seems to be better suited to restoring physiological biomechanics and preventing the development of valgus osteoarthritis of the ipsilateral knee. MDPI 2023-10-21 /pmc/articles/PMC10607773/ /pubmed/37892800 http://dx.doi.org/10.3390/jcm12206662 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thöne, Paul
Gruber, Michael Stephan
Kindermann, Harald
Gussner, Walter
Sadoghi, Patrick
Ortmaier, Reinhold
Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases
title Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases
title_full Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases
title_fullStr Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases
title_full_unstemmed Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases
title_short Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases
title_sort stem design in total hip arthroplasty influences ipsilateral knee valgus: a retrospective comparative analysis of 2953 cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607773/
https://www.ncbi.nlm.nih.gov/pubmed/37892800
http://dx.doi.org/10.3390/jcm12206662
work_keys_str_mv AT thonepaul stemdesignintotalhiparthroplastyinfluencesipsilateralkneevalgusaretrospectivecomparativeanalysisof2953cases
AT grubermichaelstephan stemdesignintotalhiparthroplastyinfluencesipsilateralkneevalgusaretrospectivecomparativeanalysisof2953cases
AT kindermannharald stemdesignintotalhiparthroplastyinfluencesipsilateralkneevalgusaretrospectivecomparativeanalysisof2953cases
AT gussnerwalter stemdesignintotalhiparthroplastyinfluencesipsilateralkneevalgusaretrospectivecomparativeanalysisof2953cases
AT sadoghipatrick stemdesignintotalhiparthroplastyinfluencesipsilateralkneevalgusaretrospectivecomparativeanalysisof2953cases
AT ortmaierreinhold stemdesignintotalhiparthroplastyinfluencesipsilateralkneevalgusaretrospectivecomparativeanalysisof2953cases