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Research article
A Comparison of Cylindrical and Tapered Stem Designs in Femoral Revision Hip Arthroplasty
Xiang-Yang Chen
Xuzhou Medical College Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7376-6179
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Musculoskeletal Disorders.
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.
Keywords
femoral revisions, hip arthroplasty, cylindrical stem, tapered stem, complications
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CURRENT STATUS: Published
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On 29 Jun, 2020
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On 25 Apr, 2020
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Received 17 Feb, 2020
Reviewer #1 agreed
On 17 Feb, 2020
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On 21 Jan, 2020
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Subject Areas
Orthopedic Surgery
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
A Comparison of Cylindrical and Tapered Stem Designs in Femoral Revision Hip Arthroplasty
Xiang-Yang Chen
Xuzhou Medical College Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7376-6179
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 31 May, 2020
Published
On 29 Jun, 2020
No community comments so far
Submission checks complete
On 22 May, 2020
No comments provided
Review #2 received
Received 26 Apr, 2020
Editorial decision: Major revision
On 26 Apr, 2020
Reviewer #2 agreed
On 25 Apr, 2020
Review #1 received
Received 17 Feb, 2020
Reviewer #1 agreed
On 17 Feb, 2020
Reviewers invited
Invitations sent on 22 Jan, 2020
Editor assigned
On 21 Jan, 2020
Submission checks complete
On 20 Jan, 2020
Editor invited
On 20 Jan, 2020
First submitted
On 12 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Musculoskeletal Disorders.
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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