Not all cementless stems are created equal: A selection algorithm
Patients, and their femurs, come in all shapes, sizes, and types. Fortunately, so do cementless femoral stems. Each surgeon should have a “go to” cementless femoral component that can address over 90% of cases. A simple approach is to separately consider (A) the part inside the bone and (B) the part...
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| Published in | Seminars in arthroplasty Vol. 27; no. 1; pp. 11 - 14 |
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| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
Elsevier Inc
01.03.2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1045-4527 |
| DOI | 10.1053/j.sart.2016.06.017 |
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| Abstract | Patients, and their femurs, come in all shapes, sizes, and types. Fortunately, so do cementless femoral stems. Each surgeon should have a “go to” cementless femoral component that can address over 90% of cases. A simple approach is to separately consider (A) the part inside the bone and (B) the part outside the bone. The inner-cortical geometry (Dorr type) and bone density influence stem size (the part inside the bone) and influence femoral canal preparation. Femoral deformity or old hardware can occasionally necessitate the use of a short stem or a modular stem. Restoration of limb length and offset is a function of the neck angle and length (the part outside the bone). Undersizing of cementless stems increases the risk of aseptic loosening while restoration of limb length and offset favorably affects patient satisfaction and function. |
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| AbstractList | Patients, and their femurs, come in all shapes, sizes, and types. Fortunately, so do cementless femoral stems. Each surgeon should have a “go to” cementless femoral component that can address over 90% of cases. A simple approach is to separately consider (A) the part inside the bone and (B) the part outside the bone. The inner-cortical geometry (Dorr type) and bone density influence stem size (the part inside the bone) and influence femoral canal preparation. Femoral deformity or old hardware can occasionally necessitate the use of a short stem or a modular stem. Restoration of limb length and offset is a function of the neck angle and length (the part outside the bone). Undersizing of cementless stems increases the risk of aseptic loosening while restoration of limb length and offset favorably affects patient satisfaction and function. Abstract Patients, and their femurs, come in all shapes, sizes, and types. Fortunately, so do cementless femoral stems. Each surgeon should have a “go to” cementless femoral component that can address over 90% of cases. A simple approach is to separately consider (A) the part inside the bone and (B) the part outside the bone. The inner-cortical geometry (Dorr type) and bone density influence stem size (the part inside the bone) and influence femoral canal preparation. Femoral deformity or old hardware can occasionally necessitate the use of a short stem or a modular stem. Restoration of limb length and offset is a function of the neck angle and length (the part outside the bone). Undersizing of cementless stems increases the risk of aseptic loosening while restoration of limb length and offset favorably affects patient satisfaction and function. |
| Author | Schmalzried, Thomas P. |
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| Cites_doi | 10.1016/j.arth.2007.12.016 10.1007/s11999-009-1092-3 10.1302/0301-620X.77B6.7593096 10.1302/0301-620X.96B4.32607 10.1016/j.arth.2011.12.019 10.1007/s11999-013-3033-4 |
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| References | MacDonald, Rosenzweig, Guerin, McCalden, Bohm, Bourne (bib1) 2010; 468 Evola, Evola, Graceffa, Sessa, Pavone, Costarella (bib3) 2014; 96-B Biant, Bruce, Assini, Walker, Walsh (bib6) 2009; 24 McGrory, Morrey, Cahalan, An, Cabanela (bib5) 1995; 77 Streit, Innmann, Merle, Bruckner, Aldinger, Gotterbarm (bib4) 2013; 471 Dalury, Kelley, Adams (bib2) 2012; 27 MacDonald (10.1053/j.sart.2016.06.017_bib1) 2010; 468 Evola (10.1053/j.sart.2016.06.017_bib3) 2014; 96-B Biant (10.1053/j.sart.2016.06.017_bib6) 2009; 24 Dalury (10.1053/j.sart.2016.06.017_bib2) 2012; 27 McGrory (10.1053/j.sart.2016.06.017_bib5) 1995; 77 Streit (10.1053/j.sart.2016.06.017_bib4) 2013; 471 |
| References_xml | – volume: 27 start-page: 1014 year: 2012 end-page: 1018 ident: bib2 article-title: Modern proximally tapered uncemented stems can be safely used in Dorr type C femoral bone publication-title: The Journal of Arthroplasty – volume: 468 start-page: 424 year: 2010 end-page: 432 ident: bib1 article-title: Proximally versus fully porous-coated femoral stems: a multicenter randomized trial publication-title: Clinical Orthopaedics and Related Research – volume: 96-B start-page: 455 year: 2014 end-page: 461 ident: bib3 article-title: Performance of the CLS Spotorno uncemented stem in the third decade after implantation publication-title: Bone Joint Journal – volume: 77 start-page: 865 year: 1995 end-page: 869 ident: bib5 article-title: Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty publication-title: The Journal of Bone and Joint Surgery. British Volume – volume: 471 start-page: 3262 year: 2013 end-page: 3269 ident: bib4 article-title: Long-term (20- to 25-year) results of an uncemented tapered titanium femoral component and factors affecting survivorship publication-title: Clinical Orthopaedics and Related Research – volume: 24 start-page: 27 year: 2009 end-page: 32 ident: bib6 article-title: Primary total hip arthroplasty in severe developmental dysplasia of the hip. Ten-year results using a cementless modular stem publication-title: The Journal of Arthroplasty – volume: 24 start-page: 27 year: 2009 ident: 10.1053/j.sart.2016.06.017_bib6 article-title: Primary total hip arthroplasty in severe developmental dysplasia of the hip. Ten-year results using a cementless modular stem publication-title: The Journal of Arthroplasty doi: 10.1016/j.arth.2007.12.016 – volume: 468 start-page: 424 year: 2010 ident: 10.1053/j.sart.2016.06.017_bib1 article-title: Proximally versus fully porous-coated femoral stems: a multicenter randomized trial publication-title: Clinical Orthopaedics and Related Research doi: 10.1007/s11999-009-1092-3 – volume: 77 start-page: 865 year: 1995 ident: 10.1053/j.sart.2016.06.017_bib5 article-title: Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty publication-title: The Journal of Bone and Joint Surgery. British Volume doi: 10.1302/0301-620X.77B6.7593096 – volume: 96-B start-page: 455 year: 2014 ident: 10.1053/j.sart.2016.06.017_bib3 article-title: Performance of the CLS Spotorno uncemented stem in the third decade after implantation publication-title: Bone Joint Journal doi: 10.1302/0301-620X.96B4.32607 – volume: 27 start-page: 1014 year: 2012 ident: 10.1053/j.sart.2016.06.017_bib2 article-title: Modern proximally tapered uncemented stems can be safely used in Dorr type C femoral bone publication-title: The Journal of Arthroplasty doi: 10.1016/j.arth.2011.12.019 – volume: 471 start-page: 3262 year: 2013 ident: 10.1053/j.sart.2016.06.017_bib4 article-title: Long-term (20- to 25-year) results of an uncemented tapered titanium femoral component and factors affecting survivorship publication-title: Clinical Orthopaedics and Related Research doi: 10.1007/s11999-013-3033-4 |
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| Snippet | Patients, and their femurs, come in all shapes, sizes, and types. Fortunately, so do cementless femoral stems. Each surgeon should have a “go to” cementless... Abstract Patients, and their femurs, come in all shapes, sizes, and types. Fortunately, so do cementless femoral stems. Each surgeon should have a “go to”... |
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| SubjectTerms | cementless stem Orthopedics pre-operative planning surgical technique total hip |
| Title | Not all cementless stems are created equal: A selection algorithm |
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