TY - JOUR
T1 - Pneumatic femoral broaching decreases post-operative subsidence of a cementless taper-wedge stem
AU - Fujii, Masanori
AU - Kitamura, Kenji
AU - Ikemura, Satoshi
AU - Hamai, Satoshi
AU - Motomura, Goro
AU - Nakashima, Yasuharu
N1 - Funding Information:
This study was funded by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (No. JP18K09109).
Publisher Copyright:
© 2021, SICOT aisbl.
PY - 2022/2
Y1 - 2022/2
N2 - Purpose: Stem subsidence is a known cause of early failure in cementless total hip arthroplasty (THA). The aim of this study was to determine the usefulness of pneumatic femoral broaching in preventing post-operative subsidence of a proximally porous-coated, taper-wedge stem. Methods: We reviewed 169 cases of primary THA with a single taper-wedge stem. Eighty THAs performed using pneumatic broaching were compared with 89 THAs performed using manual broaching in terms of postoperative canal fill ratio (CFR) at three levels, stem subsidence at one year post-operation, and stem fixation at latest follow-up (median, 24 months). Results: The median CFRs were higher in the pneumatic group than in the manual group at all levels (p < 0.05). The median stem subsidence at one year after THA was lower in the pneumatic group than in the manual group (0.2 mm vs. 0.6 mm, p = 0.007). A multivariate analysis determined a decreased CFR at 60 mm below the lesser trochanter and the manual broaching as independent factors affecting post-operative stem subsidence. At the latest follow-up, all stems showed stable fixation by bone ingrowth in both groups. Conclusion: Our results showed that the pneumatic broaching device was useful in maximizing the mediolateral canal filling and initial stability and minimizing the subsidence of taper-wedge stems.
AB - Purpose: Stem subsidence is a known cause of early failure in cementless total hip arthroplasty (THA). The aim of this study was to determine the usefulness of pneumatic femoral broaching in preventing post-operative subsidence of a proximally porous-coated, taper-wedge stem. Methods: We reviewed 169 cases of primary THA with a single taper-wedge stem. Eighty THAs performed using pneumatic broaching were compared with 89 THAs performed using manual broaching in terms of postoperative canal fill ratio (CFR) at three levels, stem subsidence at one year post-operation, and stem fixation at latest follow-up (median, 24 months). Results: The median CFRs were higher in the pneumatic group than in the manual group at all levels (p < 0.05). The median stem subsidence at one year after THA was lower in the pneumatic group than in the manual group (0.2 mm vs. 0.6 mm, p = 0.007). A multivariate analysis determined a decreased CFR at 60 mm below the lesser trochanter and the manual broaching as independent factors affecting post-operative stem subsidence. At the latest follow-up, all stems showed stable fixation by bone ingrowth in both groups. Conclusion: Our results showed that the pneumatic broaching device was useful in maximizing the mediolateral canal filling and initial stability and minimizing the subsidence of taper-wedge stems.
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U2 - 10.1007/s00264-021-05196-x
DO - 10.1007/s00264-021-05196-x
M3 - Article
C2 - 34448924
AN - SCOPUS:85113622940
SN - 0341-2695
VL - 46
SP - 233
EP - 240
JO - International Orthopaedics
JF - International Orthopaedics
IS - 2
ER -