A Comparison of Cylindrical and Tapered Stem Designs in Femoral Revision Hip Arthroplasty
Background Both cylindrical and tapered stems are commonly used in revision total hip arthroplasty, it is unclear whether the geometry of prosthesis stem has an effect on the patient's efficacy and prognosis. we assume the tapered stem is superior to the cylindrical stem for better clinical outcome.
Methods A multicenter review of 120 femoral revisions with Paprosky I, II and III defects using cobalt cylindrical stem (54 hips) or titanium tapered stem (66 hips) was performed with an average follow-up of 6 years. Demographic data was comparable between groups.
Results There were no significant group differences were found in surgery time, bleeding volume and the postoperative Harris Hip Score, the level of overall satisfaction, 8-year cumulative survival. However, intraoperative fractures in the tapered group (4.5%) occurred significantly less than in the cylindrical group (14.8%), and stem subsidence was significantly less in the tapered group (2.17mm) than in the cylindrical group (4.17 mm). There was a higher ratio of bone repair and lower bone loss in the tapered group compared to the cylindrical group. The postoperative thigh pain rate was higher in the cylindrical group (12.9%) than in the tapered group (4.5%).
Conclusion Both cylindrical stem and tapered stem can achieve satisfactory mid-term clinical results in revision THA; The tapered stem has better bone restoration of proximal femur, low incidence of intraoperative fracture, and low postoperative thigh pain rate compared with the cylindrical stem.
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Posted 31 May, 2020
On 29 Jun, 2020
On 22 May, 2020
Received 26 Apr, 2020
On 26 Apr, 2020
On 25 Apr, 2020
Received 17 Feb, 2020
On 17 Feb, 2020
Invitations sent on 22 Jan, 2020
On 21 Jan, 2020
On 20 Jan, 2020
On 20 Jan, 2020
On 12 Jan, 2020
A Comparison of Cylindrical and Tapered Stem Designs in Femoral Revision Hip Arthroplasty
Posted 31 May, 2020
On 29 Jun, 2020
On 22 May, 2020
Received 26 Apr, 2020
On 26 Apr, 2020
On 25 Apr, 2020
Received 17 Feb, 2020
On 17 Feb, 2020
Invitations sent on 22 Jan, 2020
On 21 Jan, 2020
On 20 Jan, 2020
On 20 Jan, 2020
On 12 Jan, 2020
Background Both cylindrical and tapered stems are commonly used in revision total hip arthroplasty, it is unclear whether the geometry of prosthesis stem has an effect on the patient's efficacy and prognosis. we assume the tapered stem is superior to the cylindrical stem for better clinical outcome.
Methods A multicenter review of 120 femoral revisions with Paprosky I, II and III defects using cobalt cylindrical stem (54 hips) or titanium tapered stem (66 hips) was performed with an average follow-up of 6 years. Demographic data was comparable between groups.
Results There were no significant group differences were found in surgery time, bleeding volume and the postoperative Harris Hip Score, the level of overall satisfaction, 8-year cumulative survival. However, intraoperative fractures in the tapered group (4.5%) occurred significantly less than in the cylindrical group (14.8%), and stem subsidence was significantly less in the tapered group (2.17mm) than in the cylindrical group (4.17 mm). There was a higher ratio of bone repair and lower bone loss in the tapered group compared to the cylindrical group. The postoperative thigh pain rate was higher in the cylindrical group (12.9%) than in the tapered group (4.5%).
Conclusion Both cylindrical stem and tapered stem can achieve satisfactory mid-term clinical results in revision THA; The tapered stem has better bone restoration of proximal femur, low incidence of intraoperative fracture, and low postoperative thigh pain rate compared with the cylindrical stem.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6