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KMID : 0361620230580010027
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Journal of the Korean Orthopaedic Association
2023 Volume.58 No. 1 p.27 ~ p.34
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Cementless Hip Arthroplasty Using a Long Double-Tapered Rectangular Stem in Patients with Osteoporotic Proximal Femoral Fractures or Reoperation
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Lee Han-Jin
Kim Hong-Seok
Yoo Jeong-Joon
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Abstract
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Purpose: This study examined the clinical and radiological results of cementless hip arthroplasty using a long double-tapered rectangular stem in cases with osteoporotic proximal femoral fractures or in reoperation cases.
Materials and Methods: This was a retrospective study on patients treated with a Benfix® stem (Corentec, Cheonan, Korea) by a single surgeon at a single tertiary institution from September 2011 to August 2020, where 92 hips were treated. Thirty-nine patients were followed up for less than one year. Excluding those patients, the mean follow-up duration was 3.0 years (range 1?8 years). The patients’ deaths were confirmed through data from the Ministry of Interior and Safety. Clinical outcomes were assessed using a modified Harris hip score (mHHS), and radiologic outcomes, such as fixation and subsidence, were assessed by surgeons who did not participate in the surgery.
Results: mHHS improved from 45 to 79 points at the latest follow-up, and thigh pain was not observed in 53 patients who were followed up for more than one year. Notching of the stem was not noted. The average subsidence was approximately 1 mm in postoperative one year.
Three peri-prosthetic fractures (PPF), one deep prosthetic infection, and one superficial wound infection were observed. Stem loosening occurred in one of these PPF cases, and stem revision surgery was done. All complications occurred within one year postoperatively. The one- and five-year mortality were 21.1% and 50.0%, respectively.
Conclusion: The short-term and mid-term results of the cementless hip arthroplasty using long double-tapered rectangular stem appeared encouraging and could be a viable option in osteoporotic proximal femoral fractures or reoperation cases. However, most complications occurred within one postoperative year, and the one-year mortality was relatively high. A long-term follow-up would be necessary with a larger cohort to evaluate its longevity.
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KEYWORD
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osteoporosis, hip fractures, hip replacement arthroplasty, long double-tapered rectangular stem
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