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The correlation between clinical radiological outcome and contact state of implant and femur using three-dimensional templating software in cementless total hip arthroplasty

  • Original Article • HIP - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Initial fixation is a key factor in the success of cementless THA using a tapered wedge stem. The purpose of this study was to use three-dimensional templating software to examine the correlation between quantitative contact state and important clinical radiological outcomes, specifically stem subsidence, stress shielding, and cortical hypertrophy.

Methods

We conducted a retrospective consecutive review of 75 hips in 70 patients over a minimum 3-year follow-up period. X-rays and CT scans were investigated to assess preoperative planning, quantify the contact state of implant and femur, and assess stem alignment, stem subsidence, stress shielding, and cortical hypertrophy. We evaluated the correlation between radiological outcomes and three-dimensional quantitative contact state according to Gruen Zone in each Dorr classification.

Results

Density map** indicated that stem subsidence increased postoperatively if the stem had less cortical contact in the middle to distal portion of the implant in terms of initial fixation. Cases having too much cortical contact in the distal portion of the implant tended to have increased stress shielding. We found no correlation between cortical hypertrophy and the contact state of implant and femur.

Conclusions

Density map** with three-dimensional templating software can be useful in predicting stem subsidence and stress shielding following cementless THA with a tapered wedge stem. Further analysis is required to accurately depict the correlation between cortical hypertrophy and the contact state.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan

    Daisuke Inoue, Tamon Kabata, Toru Maeda, Yoshitomo Ka**o, Takashi Yamamoto, Tomoharu Takagi, Takaaki Ohmori & Hiroyuki Tsuchiya

Authors
  1. Daisuke Inoue
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  2. Tamon Kabata
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  3. Toru Maeda
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  4. Yoshitomo Ka**o
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  5. Takashi Yamamoto
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  6. Tomoharu Takagi
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  7. Takaaki Ohmori
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  8. Hiroyuki Tsuchiya
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Corresponding author

Correspondence to Tamon Kabata.

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Conflict of interest

The authors did not receive any benefits or findings from any commercial party related directly or indirectly to the subjects of this article.

Ethical approval

All procedures performed in studies were in accordance with the ethical standards of our institutional ethical committee. In accordance with the requirements of this study, all patients provided informed consent.

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Inoue, D., Kabata, T., Maeda, T. et al. The correlation between clinical radiological outcome and contact state of implant and femur using three-dimensional templating software in cementless total hip arthroplasty. Eur J Orthop Surg Traumatol 26, 591–598 (2016). https://doi.org/10.1007/s00590-016-1796-5

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  • DOI: https://doi.org/10.1007/s00590-016-1796-5

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