Subsidence of collarless uncemented femoral stems in total hips replacements performed for trauma
Pentlow AK et al. – This study showed that collarless uncemented stems subsided significantly more when performed for fractures and had a high early revision rate. The authors recommend that uncemented collarless should not be used in trauma patients requiring total hip replacement.Methods
- Post-operative radiographs of 46 patients, mean age 71, who underwent an uncemented, collarless, total hip replacement for trauma, were reviewed.
- The difference in distance from the calcar to the prosthesis tip between the immediate post operative radiograph and the subsequent follow-up radiograph was calculated and adjusted for magnification.
- The same procedure was performed on 36 age-matched patients, who underwent elective hip replacements for osteoarthritis.
- Hospital notes were reviewed to assess for complications and DEXA scans reviewed for trauma patients where available.
- The mean femoral stem subsidence was significantly greater in the fracture cohort than in elective patients (p=0.001) with mean subsidence of 4.27mm (range 0.02–22.05mm) and 1.57mm (range 0–5.5mm), respectively.
- In the fracture cohort there were 4 revisions within 6 months of surgery, 1 for infection and 3 for femoral stem subsidence leading to dislocation.
- There were no revisions in the elective cohort.