Risk factors for impingement between the femoral stem tip and the distal femoral cortex after first total hip arthroplasty

doi:10.12307/2021.193

Abstract

Abstract: BACKGROUND: With the continuous development of total hip arthroplasty, both doctors and patients are constantly pursuing higher quality surgical results. However, high-quality total hip arthroplasty not only requires the skilled skills of the doctor, but also has a certain impact on the femoral configuration of the patient.
OBJECTIVE: To analyze the risk factors of the impingement between the femoral stem tip and the distal femoral cortex, so as to provide effective references for preoperative planning of total hip arthroplasty.
METHODS: A retrospective analysis was performed in data of 160 patients of primary total hip arthroplasty from January 2018 to January 2020. All surgeries were conducted by an experienced director of orthopedic surgeon using the buttock posterolateral approach. Postoperative anteroposterior and lateral X-ray images or CT images were observed by two orthopedic surgeons via medical image archiving and communication system or Mimics 20.0. The femoral handle sophisticated and distal femoral cortical contact or penetration was defined as the impact. There were 139 patients, including 56 males and 83 females, with a mean age of (68.1±12.3) years (range, 26-92 years). The gender, age, height, body mass, body mass index and femoral stem length (all LK.LCU stem), femoral stem insertion angle (the angle between the long axis of femoral stem and the long axis of femoral stem), femoral anterior arch angle, femoral lateral arch angle and femoral medullary cavity type were recorded. Above data were analyzed by difference analysis and Logistic regression analysis.
RESULTS AND CONCLUSION: (1) Among the 139 patients undergoing primary total hip arthroplasty, 32 (23%) had impact, including 6 males and 26 females. The average age was (68.13±10.90) years old (range, 46-85 years); body mass index (22.48±3.39) kg/m2. (2) Regression analysis suggested that factors associated with distal femoral cortical impingement included gender (P=0.036), height (P=0.018), implant angle (P=0.047), anterior femoral arch angle (P=0.000), and lateral femoral arch angle (P=0.003). (3) It is concluded that female patients with short stature, large angle of anterior femoral arch and lateral femoral arch or excessively large angle of femoral prosthesis implantation are likely to cause the femoral stalk tip impingement with the femoral cortex.

Key words: total hip arthroplasty, femoral stem, femoral arch angle, implant angle, impingement

CLC Number:

Zhang Yang, Wang Dasai, Wang Qiang. Risk factors for impingement between the femoral stem tip and the distal femoral cortex after first total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(27): 4339-4343.

Figures/Tables 5

References

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