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Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications

BACKGROUND: Limited-incision total hip arthroplasty (THA) preserves hip abductors, posterior capsule, and external rotators potentially diminishing dislocation risk. However, potential complications also exist, such as component malposition. Specific implants have been manufactured that enhance comp...

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Autores principales: Ahmed, Mohammed M., Otto, Thomas J., Moed, Berton R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840905/
https://www.ncbi.nlm.nih.gov/pubmed/27106260
http://dx.doi.org/10.1186/s13018-016-0383-0
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author Ahmed, Mohammed M.
Otto, Thomas J.
Moed, Berton R.
author_facet Ahmed, Mohammed M.
Otto, Thomas J.
Moed, Berton R.
author_sort Ahmed, Mohammed M.
collection PubMed
description BACKGROUND: Limited-incision total hip arthroplasty (THA) preserves hip abductors, posterior capsule, and external rotators potentially diminishing dislocation risk. However, potential complications also exist, such as component malposition. Specific implants have been manufactured that enhance compatibility with this technique, while preserving metaphyseal bone; however, little data exists documenting early complications and component position. The purpose was to evaluate primary THA using a curved, bone-sparing stem inserted through the anterior approach with respect to component alignment and early complications. METHODS: In a retrospective analysis of 108 cases, the surgical technique was outlined and the occurrence of intraoperative fractures, postoperative dislocations, infection, and limb length inequality was determined. Femoral stem and acetabular cup alignment was quantified using the initial postoperative radiographs. Patient follow-up averaged 12.9 (range 2 to 36) months. RESULTS: There were eight (7.4 %) complications requiring revision surgery in three (2.8 %) patients with three (2.8 %) infections and three (2.8 %) dislocations. Intraoperative complications included one calcar fracture above the lesser trochanter. Leg length inequality >5 mm was present in three (2.8 %) patients. Radiographic analysis showed that femoral neutral alignment was achieved in 95 hips (88.0 %). All femoral stems demonstrated satisfactory fit and fill and no evidence of subsidence, osteolysis, or loosening. An average abduction angle of 44.8° (±5.3) and average cup anteversion of 16.2° (±4.2) were also noted. CONCLUSIONS: Although the technique with this implant and approach is promising, it does not appear to offer important advantages over standard techniques. However, the findings merit further, long-term study.
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spelling pubmed-48409052016-04-23 Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications Ahmed, Mohammed M. Otto, Thomas J. Moed, Berton R. J Orthop Surg Res Research Article BACKGROUND: Limited-incision total hip arthroplasty (THA) preserves hip abductors, posterior capsule, and external rotators potentially diminishing dislocation risk. However, potential complications also exist, such as component malposition. Specific implants have been manufactured that enhance compatibility with this technique, while preserving metaphyseal bone; however, little data exists documenting early complications and component position. The purpose was to evaluate primary THA using a curved, bone-sparing stem inserted through the anterior approach with respect to component alignment and early complications. METHODS: In a retrospective analysis of 108 cases, the surgical technique was outlined and the occurrence of intraoperative fractures, postoperative dislocations, infection, and limb length inequality was determined. Femoral stem and acetabular cup alignment was quantified using the initial postoperative radiographs. Patient follow-up averaged 12.9 (range 2 to 36) months. RESULTS: There were eight (7.4 %) complications requiring revision surgery in three (2.8 %) patients with three (2.8 %) infections and three (2.8 %) dislocations. Intraoperative complications included one calcar fracture above the lesser trochanter. Leg length inequality >5 mm was present in three (2.8 %) patients. Radiographic analysis showed that femoral neutral alignment was achieved in 95 hips (88.0 %). All femoral stems demonstrated satisfactory fit and fill and no evidence of subsidence, osteolysis, or loosening. An average abduction angle of 44.8° (±5.3) and average cup anteversion of 16.2° (±4.2) were also noted. CONCLUSIONS: Although the technique with this implant and approach is promising, it does not appear to offer important advantages over standard techniques. However, the findings merit further, long-term study. BioMed Central 2016-04-22 /pmc/articles/PMC4840905/ /pubmed/27106260 http://dx.doi.org/10.1186/s13018-016-0383-0 Text en © Ahmed et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ahmed, Mohammed M.
Otto, Thomas J.
Moed, Berton R.
Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications
title Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications
title_full Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications
title_fullStr Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications
title_full_unstemmed Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications
title_short Anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications
title_sort anterior total hip arthroplasty using a metaphyseal bone-sparing stem: component alignment and early complications
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840905/
https://www.ncbi.nlm.nih.gov/pubmed/27106260
http://dx.doi.org/10.1186/s13018-016-0383-0
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