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Middle-term results of anatomic medullary locking total hip arthroplasty

Authors
  • Ohsawa, S.1
  • Fukuda, K.2
  • Matsushita, S.3
  • Mori, S.3
  • Norimatsu, H.3
  • Ueno, R.4
  • 1 Department of Rehabilitation Medicine, Osaka Rosai Hospital, 1179-3, Nagasone cho, Sakai, Osaka 591-8025, Japan Tel.: +81-722-52-3561 Fax: +81-722-50-5492, JP
  • 2 Department of Orthopaedic Surgery, Osaka Teishin Hospital, 2-6-40 Karasugatsuji, Tennohji-ku, Osaka 543, Japan, JP
  • 3 Department of Orthopaedic Surgery, Kagawa Medical School, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-07, Japan, JP
  • 4 Hoshigaoka Koseinenkin Hospital, 4-8-1 Hoshigaoka, Hirakata, Osaka 573, Japan, JP
Type
Published Article
Journal
Archives of Orthopaedic and Trauma Surgery
Publisher
Springer-Verlag
Publication Date
Nov 01, 1998
Volume
118
Issue
1-2
Pages
14–20
Identifiers
DOI: 10.1007/s004020050302
Source
Springer Nature
Keywords
License
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Abstract

We report the results of cementless, anatomic, medullary locking hip prosthesis application in our first consecutive series. We used the so-called Asian size of prosthesis with proportionally smaller stem sizes in both diameter and length. Forty-seven stems and sockets were analyzed with a mean follow-up of 69 months. The mean Merle d’Aubigné hip scores were 8 points preoperatively and 16 points at the final follow-up. Radiologically, the stems showed excellent stability without loosening. Stress shielding around the stems did occur in most cases but did not progress. Preoperative bone quality influenced the extent of stress shielding evaluated at the final follow-up: higher stress shielding was noted in poorer quality bones at the time of operation. There were problems with the sockets. The shallow socket and impingement at the protruded rim seemed to cause a high incidence of dislocation (13%). Massive polyethylene wear occurred in 5 sockets. These sockets were 48 and 46 mm in diameter with 26 mm heads. In conclusion, the stems of the anatomic medullary locking hip prostheses used in Japan showed satisfactory stability even in poor quality bones, but there were problems with the polyethylene liners. Our solution was to use larger sockets with 22 mm heads.

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