Do Stem Design and Surgical Approach Influence Early Aseptic Loosening in Cementless THA?

Clinical Orthopaedics and Related Research
Loes JanssenJan W Morrenhof

Abstract

Some studies have revealed an increased risk of early aseptic loosening of cementless stems in THA when inserted through an anterior or anterolateral approach compared with a posterior approach, whereas approach does not appear to be a risk factor in others. Stem design, whether "anatomic" (that is, stems with a curved lateral profile or an obtuse angle at the proximal-lateral portion of the stem) or "shoulder" (that is, straight with a proximal shoulder), may also be associated with a differential risk of aseptic loosening in cementless THA depending on the surgical approach used, but if so, this risk is not well characterized. In this national registry study, we investigated the association between surgical approach and early aseptic loosening of (1) cementless femoral stems with a proximal angular shape (shoulder); and (2) anatomically shaped femoral stems. The Dutch Arthroplasty Registry is a nationwide population-based register recording data on primary and revision hip arthroplasty. We selected all primary THAs (n = 63,354) with a cementless femoral stem inserted through an anterior, anterolateral, or posterior approach from 2007 to 2013 with a minimal followup of 2 years. Femoral stems were classified as "anatomic," "sho...Continue Reading

References

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Citations

Aug 7, 2019·Clinical Pharmacokinetics·Nikki BlosserDouglas Stewart
Jul 22, 2020·ANZ Journal of Surgery·Wayne HoskinsPeter F M Choong
Jan 8, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Eduardo García-Rey
Jul 15, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·George A MacherasTheofilos S Karachalios
Aug 10, 2020·The Journal of Bone and Joint Surgery. American Volume·Wayne HoskinsRichard N de Steiger
Sep 22, 2020·Journal of Orthopaedics·Jurek Rafal Tomasz PietrzakJosip Nenad Cakic
Nov 12, 2020·Revista española de cirugía ortopédica y traumatología·E García ReyJ Ortega Chamarro

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