J Korean Orthop Assoc.  2012 Aug;47(4):286-292. 10.4055/jkoa.2012.47.4.286.

Minimum 5-Year Results of Titanium Tapered Stem with Alumina Bearing in Cementless Total Hip Arthroplasty Using a Modified Direct Lateral Approach

• Yoon PW
• Jeong HJ
• Lee JH
• Kang SB
• Lee JH
• Jo CH
• Han HS
• Rhee SH
• Kim J
• Yoon KS

• KMID: 2185376
• DOI: http://doi.org/10.4055/jkoa.2012.47.4.286

Abstract

PURPOSE
The purpose of the current study is to evaluate the clinical and radiographic outcomes of primary total hip arthroplasty (THA) using a single titanium tapered stem with alumina bearing, which was performed through a modified direct lateral approach.
MATERIALS AND METHODS
One hundred twenty consecutive primary THAs were performed in 102 patients, and retrospectively reviewed. There were 53 men and 49 women of mean age 54 years, and all patients were followed for a minimum follow-up period of 5 years (range, 5-8.1 years). Clinical outcomes assessment consisted of calculation of the Harris hip score (HHS), and evaluation of the presence of thigh pain or limp. Sequential radiographs were evaluated for implant migration, osteolysis, reactive line, cortical hypertrophy, or evidence of component loosening.
RESULTS
At the final follow-up, the mean preoperative HHS of 46 points improved to 94 points; and activity-related thigh pain occurred in two hips, and mild limps in four hips. There was no evidence of implant migration, osteolysis, or component loosening. Audible squeaking was present in two hips, without pain and radiographic abnormality. Dislocation occurred in three hips.
CONCLUSION
The minimum 5-year results of titanium tapered stem with alumina bearing in cementless primary THA, using a modified direct lateral approach, were encouraging.

Keyword

hip; total hip replacement; alumina ceramic; prosthesis

MeSH Terms

Aldosterone
Aluminum Oxide
Arthroplasty
Arthroplasty, Replacement, Hip
Dislocations
Female
Follow-Up Studies
Hip
Humans
Hypertrophy
Male
Osteolysis
Outcome Assessment (Health Care)
Prostheses and Implants
Retrospective Studies
Tacrine
Thigh
Titanium
Ursidae
Aldosterone
Aluminum Oxide
Tacrine
Titanium

Figure

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  Figure 1 Modified direct lateral approach. (A) Marking of musculoosseous sleeve composed of the anterior 2/3 of the gluteus medius and minimus, anterior trochanteric fragement, and the anterior 1/3 of vastus lateralis. (B) Osteotomy is oriented in coronal plane. G, gluteus medius; T, greater trochanter; V, vastus lateralis.

• 

  Figure 2 (A) Musculoosseous sleeve is reflected anteriorly (asterisk: reflected anterior trochanteric fragment, arrow: gluteus minimus). (B) The anterior joint capsule J is exposed through dissection the interval between the abductors and the capsule.

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  Figure 3 (A) An immediate postoperative radiograph. (B) The radiograph taken 6 years after surgery shows calcar rounding (arrow).

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  Figure 4 (A) An immediate postoperative radiograph. (B) Distal cortical hypertrophy (arrow) was observed on the radiograph taken 5 years after surgery, which was asymptomatic.

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  Figure 5 (A) An immediate postoperative radiograph. (B) The radiograph taken 7 years after surgery shows radiodense line without progression (arrows). This patient was pain-free and showed no clinical signs of instability.

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  Figure 6 Circumferential wiring was performed due to a calcar crack sustained during stem insertion and the crack healed without stem migration.

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