Journal of Orthopaedics and Traumatology

, Volume 1, Issue 1, pp 31–39

Preservation of the femoral neck in hip arthroplasty: results of a 13- to 17-year follow-up


  • Francesco Pipino
    • Orthopedics Clinic, University in Genoa, Genoa, Italy, Tel.: +39-010-3537759, Fax: +39-010-3537379, E-mail:
  • Luigi Molfetta
    • Orthopedics Clinic, University in Genoa, Genoa, Italy, Tel.: +39-010-3537759, Fax: +39-010-3537379, E-mail:
  • Michele Grandizio
    • Orthopedics Clinic, University in Genoa, Genoa, Italy, Tel.: +39-010-3537759, Fax: +39-010-3537379, E-mail:

DOI: 10.1007/s101950070026

Cite this article as:
Pipino, F., Molfetta, L. & Grandizio, M. J Orthopaed Traumatol (2000) 1: 31. doi:10.1007/s101950070026


In prosthetic surgery of the hip, it is important to remove only the pathological tissues, preserving as much as possible the osteo-articular architecture, in particular the femoral neck and the subchondral cencellous acetabulum. This allows the bone to easily adapt to the new biomechanical situation created by the prosthesis. Our long-term study of patients who underwent total hip replacement has confirmed such presuppositions. For this study, we used a biodynamic prosthesis, composed of a Lord hemispheric screwed cup with a biequatorial liner and an anatomical stem in Cr-Co-Md with a completely madreporic surface. This prosthesis is ideally configured to preserve the femoral neck. We followed 44 prostheses for 13–17 years. The clinical results were excellent or good in 82% of cases. Thigh pain, reported in only 14% of cases, spontaneously resolved. The mobility of the prosthetic hip and the consequent functional recovery were excellent, since conserving the neck re-stabilized the natural off-set, providing good equilibrium of the hip and the periarticular muscles. Radiographic analysis revealed survival of the femoral neck in approximately 80% of cases. The madreporic surface, when associated with correct positioning of an undersized stem, allowed for osteointegration with significant bone remodeling in the long term. Distal cortical hypertropy, found in 48% of cases, made it necessary to limit the madreporic surface finish to the stem's proximal two-thirds, leaving the distal one-third smooth.

Key words Total hip arthroplastyFemoral neck preservationBiequatorial linerMadreporic surface
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© Springer-Verlag Italia 2000