Copyright
©The Author(s) 2022.
World J Orthop. May 18, 2022; 13(5): 444-453
Published online May 18, 2022. doi: 10.5312/wjo.v13.i5.444
Published online May 18, 2022. doi: 10.5312/wjo.v13.i5.444
Table 1 Intraclass correlation coefficients
Neck-filling ratio | Seating height | Lateral stem contact | Subsidence | |
Intra-observer | ||||
Observer 1 | 0.85 (95%CI: 0.72-0.93) | 0.99 (95%CI: 0.99-0.99) | 0.98 (95%CI: 0.97-0.99) | 0.99 (95%CI: 0.99-0.99) |
Observer 2 | 0.83 (95%CI: 0.68-0.91) | 0.98 (95%CI: 0.98-0.99) | 0.97 (95%CI: 0.95-0.99) | 0.99 (95%CI: 0.99-1.0) |
Inter-observer | 0.77 (95%CI: 0.71-0.81) | 0.99 (95%CI: 0.99-0.99) | 0.97 (95%CI: 0.96-0.98) | 0.99 (95%CI: 0.98-0.99) |
Table 2 Demographic data
Parameters | Values |
No. of hips | 274 |
Gender (male/female) | 186/88 |
mean age (yr) (range, SD) | 48.1 (18-73, 11.2) |
mean BMI (range, SD) (kg/m2) | 23.8 (14.7-40.9, 4.3) |
Dorr’s classification, n (%) | |
Dorr’s type A | 223 (81.4) |
Dorr’s type B | 51 (18.6) |
Diagnosis, n (%) | |
ONFH | 213 (77.7) |
DDH | 33 (12.1) |
Primary osteoarthritis of the hip | 19 (6.9) |
Femoral neck fracture | 9 (3.3) |
Table 3 Results of subsidence of any radiographic parameters in the entire cohort
Parameters (n) | Value, mean (mm) (range, SD) | P value |
Subsidence of the entire cohort (75/274) | 0.5 (0-12.7, 1.68) | |
Subsidence of any radiographic parameters | ||
Neck-filling ratio < 0.8 (232) | 0.51 (0-11.89, 1.44) | 0.99 |
Neck-filling ratio ≥ 0.8 (42) | 0.5 (0-12.7, 2.02) | |
Seating height < 5 mm (110) | 0.51 (0-12.7, 0.16) | 0.99 |
Seating height ≥ 5 mm (164) | 0.5 (0-11.89, 0.11) | |
Lateral stem contact < 1 mm (178) | 0.39 (0-11.89, 1.26) | 0.09 |
Lateral stem contact ≥ 1 mm (96) | 0.71 (0-12.7, 1.94) |
Table 4 Results of univariate regression analysis of 12 cases with significant subsidence
Variables | Univariate analysis | ||
OR | 95%CI | P value | |
Age (≥ 60 yr) | 0.96 | 0.2-4.6 | 0.96 |
DDH | 0.65 | 0.1-5.2 | 0.69 |
ONFH | 3.3 | 0.4-25.8 | 0.26 |
BMI (≥ 30 kg/m2) | 0.95 | 0.1-7.6 | 0.96 |
Dorr’s type B | 2.29 | 0.6-7.9 | 0.19 |
Seating height (< 5 mm) | 0.91 | 0.3-2.9 | 0.87 |
NFR (< 0.8) | 1.98 | 0.2-15.7 | 0.52 |
Insufficient lateral stem contact (≥ 1 mm) | 5.02 | 1.3-18.9 | 0.0171 |
Table 5 Summary of stem subsidence at two years follow-up for different types of short stems
Ref. | Femoral stem | Khanuja et al[18] classification | Follow-up (mo) | Subsidence(mm) | n |
Christiansen et al[26] | Primoris, Biomed, UK | 1 | 24 | 0.38 | 50 |
Schwarze et al[25] | Metha, Aesculap, Germany | 2A | 24 | 0.86 | 39 |
Jahnke et al[24] | Metha, Aesculap, Germany | 2A | 24 | 1.28 ± 2.24 | 71 |
This study | Metha, Aesculap, Germany | 2A | 24 | 0.5 | 274 |
Budde et al[27] | Nanos, Smith + nephew, Germany | 2A | 24 | 0.46 ± 0.31 | 18 |
Ferguson et al[28] | MiniHip, Corin, UK | 2A | 24 | 0.26 | 20 |
Kutzner et al[23] | Optimys, Mathys AG, Switzerland | 2B | 24 | 1.23 (contact); 2.07 (non-contact) | 191 |
Klein et al[31] | CFP, Link, Germany | 2B | 24 | 0.3 (0.2-0.4) | 39 |
Mahmoud et al[29] | Proxima, DePuy, UK | 3 | 24 | 0.22 | 28 |
Acklin et al[30] | Fitmore, Zimmer, Switzerland | 4 | 24 | 0.39 | 24 |
- Citation: Suksathien Y, Chuvanichanon P, Tippimanchai T, Sueajui J. Insufficient lateral stem contact is an influencing factor for significant subsidence in cementless short stem total hip arthroplasty. World J Orthop 2022; 13(5): 444-453
- URL: https://www.wjgnet.com/2218-5836/full/v13/i5/444.htm
- DOI: https://dx.doi.org/10.5312/wjo.v13.i5.444