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The effects of length of femoral stem on aseptic loosening following cemented distal femoral endoprosthetic replacement in tumour surgery

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Abstract

Purpose

Aseptic loosening is a common prosthetic failure mode. The purpose of this study was to identify dose-response relationship between length of femoral stem and aseptic loosening.

Methods

We collected data of patients who underwent distal femoral prosthetic replacements at our institution from 2001 to 2017. Cox regression and two-piecewise regression model were used to analyze the associations between stem length and aseptic loosening.

Results

Significant association of length of femoral stem with aseptic loosening was observed in multivariate model and a non-linear relationship could be found from the smoothed curve. In two-piecewise model, an inflection point was calculated to be 143 mm. On the left of the inflection point, every 1 mm increase in the length of stem indicated that the risk of aseptic loosening could be reduced by 6%.

Conclusion

There was a significant non-linear relationship between the length of femoral stem and aseptic loosening, and the inflection point was 143 mm.

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Acknowledgments

We thank all participating patients and their families.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Funding

There was no funding for this study.

Author information

Author notes

  1. Hao-ran Zhang and Jing-yu Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Bone Tumor, Tianjin Hospital, 406 Jiefang Southern Road, Tianjin, China

    Hao-ran Zhang, Jing-yu Zhang, Zhi-peng Ren & Yong-cheng Hu

  2. Graduate School, Tianjin Medical University, 22 Qixiangtai Road, Tianjin, China

    Xiong-gang Yang, Rui-qi Qiao & Ji-kai Li

Authors
  1. Hao-ran Zhang
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  2. Jing-yu Zhang
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  3. Xiong-gang Yang
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  5. Ji-kai Li
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  6. Zhi-peng Ren
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  7. Yong-cheng Hu
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Corresponding author

Correspondence to Yong-cheng Hu.

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The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the ethics committee of the Tianjin Hospital.

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Zhang, Hr., Zhang, Jy., Yang, Xg. et al. The effects of length of femoral stem on aseptic loosening following cemented distal femoral endoprosthetic replacement in tumour surgery. International Orthopaedics (SICOT) 44, 1427–1433 (2020). https://doi.org/10.1007/s00264-020-04629-3

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  • DOI: https://doi.org/10.1007/s00264-020-04629-3

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