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International Orthopaedics

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01-05-2021 | Hip-TEP | Original Paper

Does increased diameter of metal femoral head associated with highly cross-linked polyethylene augment stress on the femoral stem and cortical hypertrophy?

Authors: Seiya Ishii, Yasuhiro Homma, Tomonori Baba, Yuichi Shirogane, Kazuo Kaneko, Muneaki Ishijima

Published in: International Orthopaedics | Issue 5/2021

Abstract

Purpose

Cortical hypertrophy (CH) after total hip arthroplasty (THA) is thought as a process of femoral cortical functional adaptation against the stem. However, no study has been performed to investigate the association between CH and femoral head size. The purpose of this study is to investigate the factors related to femoral CH around the cementless stem after THA.

Methods

THAs in 31 patients using 36-mm metal head and as a control, age-matched 62 THAs with 32-mm metal head have been analyzed. Radiographs were reviewed at four years to determine cortical thickness change from immediate post-operative one. Pre-operative and immediate post-operative radiographs were used to calculate the femoral morphology, canal fill ratio, stem alignment, and femoral and acetabular offset. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for CH.

Results

Patients with a 36-mm metal head had a significantly higher rate of severe CH (P = 0.001) than those with a 32-mm metal head. The multivariate logistic regression analysis with dependent variables of CH showed that the use of a 36-mm metal head had a significantly positive effect on CH. The odds ratio of a 36-mm metal head in mild CH was 2.517 (95% confidence interval, 1.032–6.143; P = 0.043), and that in severe CH was 8.273 (95% confidence interval, 2.679–25.551; P = 0.000). Age and the canal flare index were weakly and negatively influenced by mild CH.

Conclusions

The use of a 36-mm metal head was the dominant risk factor for CH.

American Joint Replacement Registry (AJRR) (2012) 2019 Annual Report. American Academy of Orthopaedic Surgeons (AAOS), Rosemont

American Joint Replacement Registry (AJRR) (2019) 2019 Annual Report. American Academy of Orthopaedic Surgeons (AAOS), Rosemont

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Title: Does increased diameter of metal femoral head associated with highly cross-linked polyethylene augment stress on the femoral stem and cortical hypertrophy?
Authors: Seiya Ishii
Yasuhiro Homma
Tomonori Baba
Yuichi Shirogane
Kazuo Kaneko
Muneaki Ishijima
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keywords: Hip-TEP
Hip-TEP
Published in: International Orthopaedics / Issue 5/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-04994-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Does increased diameter of metal femoral head associated with highly cross-linked polyethylene augment stress on the femoral stem and cortical hypertrophy?

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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