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Dual offset metaphyseal-filling stems in primary total hip arthroplasty in dysplastic hips after a minimum follow-up of ten years

International Orthopaedics volume 43, pages 2039–2046 (2019)Cite this article

Abstract

Purpose

The aim of this study was to assess the long-term performance of tapered one-third proximally coated stems in dysplastic hips.

Methods

This study included 135 dysplasia patients (150 hips) who underwent a total hip arthroplasty and had a minimum follow-up of ten years. Single design tapered stems were used in all patients. There were 112 women (83%) and 23 men (17%) with a mean age of 45 years (23 to 72) at the time of surgery. The mean follow-up was 14.7 years (10 to 16.8). For clinical evaluation, the Harris Hip Score and Merle D’Aubigne scale were used pre-operatively and at the final follow-up. Implant survival was calculated using Kaplan-Meier survivorship analysis, with failure defined as a component revision for any reason.

Results

Overall, one stem was revised for a deep infection. There were no other femoral stem revisions secondary to loosening, wear, periprosthetic fracture, or instability. Radiographic evaluation showed excellent stem osteointegration in all cases. Kaplan-Meier survivorship, with stem revision for any reason as the end point, was 98% at 14 years (95% confidence interval 92.5 to 99.8).

Conclusion

This study demonstrates that a dual offset tapered stem achieved excellent survivorship and stability, as well as good clinical outcome scores with minimal thigh pain and stress shielding in patients with arthritis and developmental dysplasia of the hip; a dual offset tapered stem may be a suitable option for primary total hip arthroplasty in this group.

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Acknowledgements

IRB of Acibadem University, Acibadem School of Medicine approved this clinical study. Date: 12 May 2016 Number: ATADEK 2016-8/17.

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Affiliations

  1. Acibadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Orthopedics and Traumatology, Acibadem Maslak Hospital, Buyukdere Cad No 40 34457, Maslak, Istanbul, Turkey

    Goksel Dikmen, Vahit Emre Ozden & Ismail Remzi Tozun

  2. Department of Orthopedics and Traumatology, Acibadem Maslak Hospital, Buyukdere Cad No 40 34457, Maslak, Istanbul, Turkey

    Burak Beksac

Authors
  1. Goksel Dikmen
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  2. Vahit Emre Ozden
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  3. Burak Beksac
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Contributions

All the authors designed the study, revised the manuscript, and approved the final draft.

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Correspondence to Goksel Dikmen.

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The authors declare that they have no conflict of interest.

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Dikmen, G., Ozden, V.E., Beksac, B. et al. Dual offset metaphyseal-filling stems in primary total hip arthroplasty in dysplastic hips after a minimum follow-up of ten years. International Orthopaedics (SICOT) 43, 2039–2046 (2019). https://doi.org/10.1007/s00264-018-4161-y

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  • DOI: https://doi.org/10.1007/s00264-018-4161-y

Keywords

  • Tapered stem
  • Dysplasia
  • Primary total hip arthroplasty
  • Long-term outcome