Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem
Background. Because the tapered wedge-shaped type cementless stem has a small anteroposterior width and a low occupation rate in the medullary space, postoperative rotational instability and stem subsidence due to inadequate proximal fixation are concerns. The purpose of this study was to clarify th...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2020/2180260 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832546878277812224 |
|---|---|
| author | Yosuke Iwamoto Hiroaki Kijima Hiroshi Tazawa Natsuo Konishi Hitoshi Kubota Shin Yamada Takayuki Tani Keiji Kamo Norio Suzuki Yoshihiko Okudera Masashi Fujii Ken Sasaki Tetsuya Kawano Itsuki Nagahata Naohisa Miyakoshi Yoichi Shimada |
| author_facet | Yosuke Iwamoto Hiroaki Kijima Hiroshi Tazawa Natsuo Konishi Hitoshi Kubota Shin Yamada Takayuki Tani Keiji Kamo Norio Suzuki Yoshihiko Okudera Masashi Fujii Ken Sasaki Tetsuya Kawano Itsuki Nagahata Naohisa Miyakoshi Yoichi Shimada |
| author_sort | Yosuke Iwamoto |
| collection | DOAJ |
| description | Background. Because the tapered wedge-shaped type cementless stem has a small anteroposterior width and a low occupation rate in the medullary space, postoperative rotational instability and stem subsidence due to inadequate proximal fixation are concerns. The purpose of this study was to clarify the relationship between the rotational instability of the tapered wedge-shaped type cementless stem and femoral canal shape. Methods. A total of 61 primary total hip arthroplasties with the tapered wedge-shaped type cementless stem Accolade® TMZF (11 males, 50 females; mean age 60 years) from January 2012 to June 2015 who underwent computed tomography before surgery and within 4 weeks and 1 year after surgery were evaluated. The preoperative femoral neck anteversion angle, preoperative femoral canal flair index, the degree of postoperative stem subsidence within 1 year after operation, and the degree of rotational change in the stem setting angle within 1 year after operation were investigated. Results. The mean preoperative femoral neck anteversion angle was 32.2° ± 17.8° (0°–69°), and the mean preoperative canal flair index was 3.68 ± 0.58 (2.44–5.55). There were no stem subsidence cases within 1 year after operation. The mean degree of rotational change in the stem from immediately to 1 year after surgery was −0.4° ± 1.7° (−3°–3°). There was no significant correlation between the canal flair index and the rotational change in the stem. In addition, the mean difference between the preoperative femoral neck anteversion angle and the stem rotational angle immediately after surgery was only 1.3° ± 5.3° (−29°–15°). Conclusions. In all cases, including stove-pipe cases, the degree of rotational change in the Accolade® TMZF stem from immediately to 1 year after surgery was within 3°. In other words, regardless of femoral canal shape, the tapered wedge-shaped type cementless stem has little initial rotational instability. |
| format | Article |
| id | doaj-art-619c83906b57465aafb057f821a8c82e |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-619c83906b57465aafb057f821a8c82e2025-02-03T06:46:55ZengWileyAdvances in Orthopedics2090-34642090-34722020-01-01202010.1155/2020/21802602180260Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless StemYosuke Iwamoto0Hiroaki Kijima1Hiroshi Tazawa2Natsuo Konishi3Hitoshi Kubota4Shin Yamada5Takayuki Tani6Keiji Kamo7Norio Suzuki8Yoshihiko Okudera9Masashi Fujii10Ken Sasaki11Tetsuya Kawano12Itsuki Nagahata13Naohisa Miyakoshi14Yoichi Shimada15Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, JapanDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanAkita Hip Research Group, 1-1-1 Hondo, Akita 010-8543, JapanDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, JapanDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, JapanDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, JapanBackground. Because the tapered wedge-shaped type cementless stem has a small anteroposterior width and a low occupation rate in the medullary space, postoperative rotational instability and stem subsidence due to inadequate proximal fixation are concerns. The purpose of this study was to clarify the relationship between the rotational instability of the tapered wedge-shaped type cementless stem and femoral canal shape. Methods. A total of 61 primary total hip arthroplasties with the tapered wedge-shaped type cementless stem Accolade® TMZF (11 males, 50 females; mean age 60 years) from January 2012 to June 2015 who underwent computed tomography before surgery and within 4 weeks and 1 year after surgery were evaluated. The preoperative femoral neck anteversion angle, preoperative femoral canal flair index, the degree of postoperative stem subsidence within 1 year after operation, and the degree of rotational change in the stem setting angle within 1 year after operation were investigated. Results. The mean preoperative femoral neck anteversion angle was 32.2° ± 17.8° (0°–69°), and the mean preoperative canal flair index was 3.68 ± 0.58 (2.44–5.55). There were no stem subsidence cases within 1 year after operation. The mean degree of rotational change in the stem from immediately to 1 year after surgery was −0.4° ± 1.7° (−3°–3°). There was no significant correlation between the canal flair index and the rotational change in the stem. In addition, the mean difference between the preoperative femoral neck anteversion angle and the stem rotational angle immediately after surgery was only 1.3° ± 5.3° (−29°–15°). Conclusions. In all cases, including stove-pipe cases, the degree of rotational change in the Accolade® TMZF stem from immediately to 1 year after surgery was within 3°. In other words, regardless of femoral canal shape, the tapered wedge-shaped type cementless stem has little initial rotational instability.http://dx.doi.org/10.1155/2020/2180260 |
| spellingShingle | Yosuke Iwamoto Hiroaki Kijima Hiroshi Tazawa Natsuo Konishi Hitoshi Kubota Shin Yamada Takayuki Tani Keiji Kamo Norio Suzuki Yoshihiko Okudera Masashi Fujii Ken Sasaki Tetsuya Kawano Itsuki Nagahata Naohisa Miyakoshi Yoichi Shimada Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem Advances in Orthopedics |
| title | Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem |
| title_full | Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem |
| title_fullStr | Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem |
| title_full_unstemmed | Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem |
| title_short | Initial Rotational Instability of the Tapered Wedge-Shaped Type Cementless Stem |
| title_sort | initial rotational instability of the tapered wedge shaped type cementless stem |
| url | http://dx.doi.org/10.1155/2020/2180260 |
| work_keys_str_mv | AT yosukeiwamoto initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT hiroakikijima initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT hiroshitazawa initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT natsuokonishi initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT hitoshikubota initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT shinyamada initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT takayukitani initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT keijikamo initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT noriosuzuki initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT yoshihikookudera initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT masashifujii initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT kensasaki initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT tetsuyakawano initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT itsukinagahata initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT naohisamiyakoshi initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem AT yoichishimada initialrotationalinstabilityofthetaperedwedgeshapedtypecementlessstem |