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Postoperative migration of the anatomical and functional anteversion angle following total hip arthroplasty with a well-fixed cemented femoral component with line-to-line implantation

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Abstract

Introduction

Little is known about the association between well-fixed polished tapered cemented stems (PTCS) implanted by the line-to-line technique and changes of stem migration, or the change of functional anteversion of the femur after total hip arthroplasty (THA).

Materials and methods

This retrospective study included 422 two-stage bilateral primary THAs performed using PTCS implanted by the line-to-line technique. CT scans were made on both the target side (first postoperative CT) and on the contralateral side (second postoperative CT) 1 week postoperatively. The mean follow-up was 7.8 months. CT data for each scan were transferred to 3D template software (Zed hip, Lexi, Japan). The postoperative changes of anatomical stem anteversion (ASA), functional femoral anteversion (FFA), and stem subsidence were evaluated.

Results

A total of 20 THAs with CT scans were available on 3D template software. The ASA and the FFA had migrated − 0.68° ± 0.62° and − 5.5° ± 9.7°, respectively, over the follow-up period. A significant positive correlation was observed between the change of subsidence and ASA (r2 = 0.34, p = 0.007), between the FFA on the second postoperative CT and ASA on the first postoperative CT (r2 = 0.26, p = 0.02) and between the FFA on the second postoperative CT and FFA on the first postoperative CT (r2 = 0.52, p = 0.0003).

Conclusion

This study indicates that the change in axial rotation of a PTCS implanted by the line-to-line technique was less than that reported by other studies and the preoperative external rotation contracture was substantially improved after THA.

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Acknowledgements

We are grateful to Dr. Satoshi Iida, Dr. Chiho Suzuki, Dr. Junichi Nakamura, Dr. Yuya Kawarai, Dr. Takushi Nakatani, Associate Professor Sumihisa Orita and Professor Seiji Ohtori head of our department, for their valuable suggestions and support during the course of this study. All authors have read and approved the submitted version. Study design: Shuichi Miyamoto, Satoshi Iida, Sumihisa Orita, Seiji Ohtori. Drafting the protocol: Shuichi Miyamoto, Satoshi Iida. Advice on the statistical analysis: Shuichi Miyamoto, Junichi Nakamura, Sumihisa Orita. Patient recruitment and data collection: Chiho Suzuki, Yuya Kawarai, Takushi Nakatani. First draft of the manuscript: Shuichi Miyamoto.

Funding

No author received any funding or financial support that may be perceived to have biased the study.

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Authors and Affiliations

  1. Matsudo City General Hospital, 993-1 Sendabori, Matsudo, Chiba, 270-2296, Japan

    Shuichi Miyamoto, Satoshi Iida, Chiho Suzuki & Takushi Nakatani

  2. Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan

    Yuya Kawarai, Junichi Nakamura & Seiji Ohtori

  3. Center for Advanced Joint Function and Reconstructive Spine Surgery Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba, 260-8670, Japan

    Sumihisa Orita

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  1. Shuichi Miyamoto
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Correspondence to Shuichi Miyamoto.

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The study protocol was in accordance with the Declaration of Helsinki for human research and approved by the Matsudo City General Hospital ethics committee.

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Miyamoto, S., Iida, S., Suzuki, C. et al. Postoperative migration of the anatomical and functional anteversion angle following total hip arthroplasty with a well-fixed cemented femoral component with line-to-line implantation. Eur J Orthop Surg Traumatol 30, 1067–1074 (2020). https://doi.org/10.1007/s00590-020-02671-w

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