J Korean Orthop Assoc.  2013 Dec;48(6):426-432. 10.4055/jkoa.2013.48.6.426.

Cementless Total Hip Arthroplasty Using the Conical Femoral Stem

• Park SS
• Lee SH
• Kim WH
• Ha SH

• KMID: 2185276
• DOI: http://doi.org/10.4055/jkoa.2013.48.6.426

Abstract

PURPOSE
The purpose of this study is to evaluate the clinical and radiological results of cementless total hip arthroplasty using a conical stem.
MATERIALS AND METHODS
From June 2005 to December 2007, total hip arthroplasty using the conical stem was performed in 47 patients and 51 hips. The most common causes for total hip arthroplaty were osteonecrosis of the femoral head in 32 cases. The mean follow-up period was 74.3 months (range: 62-93 months) and the mean age was 51.2 years (range: 36-84 years). The clinical evaluation included the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and pain on the inguinal area or thigh. Radiographic evaluation was performed for determination of the fixation status of the implant, the radiolucent line, subsidence, loosening and heterotopic ossification around the acetabular cup and the femoral stem.
RESULTS
At the most recent follow-up, the mean Harris hip score was 94.1 points and the WOMAC score was 11.3 points. Radiologically, bone ongrowth was seen in all cases without migration of acetabular cup, femoral stem, changing of the position, subsidence and loosening. Complications included two cases of posterior dislocation, one case of heterotopic ossification, and one case of deep vein thrombosis.
CONCLUSION
Cementless total hip arthroplasty using the conical femoral stem shows good clinical and radiologic results in treatment of osteonecrosis of the femoral head with normal canal flare index and femur neck fracture with stove pipe type.

Keyword

conical femoral stem; cementless total hip arthroplasty

MeSH Terms

Acetabulum
Arthroplasty, Replacement, Hip*
Dislocations
Femoral Neck Fractures
Follow-Up Studies
Head
Hip
Humans
Ontario
Ossification, Heterotopic
Osteoarthritis
Osteonecrosis
Thigh
Venous Thrombosis

Figure

• 

  Figure 1 (A) Characteristics of the Wagner cone stem. It has a tapered angle of 5 degrees with eight sharp longitudinal ridges. It consists of a coarse blasted titanium surface for osseointegration. (B) haracteristics of the Fitmore cup. The outer surface of the implant consists of a 4-layered grid made of titanium. If press-fit stability is not achieved, screw fixation is necessary for optional stabilization.

• 

  Figure 2 (A) Radiograph of a 50-year-old male with avascular necrosis of the left hip with stove pipe canal type. (B) Immediate postoperative anteroposterior hip radiograph. (C, D) The hip anterioposterior and lateral radiograph shows no subsidence or osteolysis at six years after the operation.

• 

  Figure 3 (A) Radiograph of a 70-year-old male with avascular necrosis of the right hip with stove pipe canal type. (B) Immediate postoperative anteroposterior hip radiograph. (C, D) Hip anterioposterior and lateral radiograph showing no subsidence or osteolysis at 6.5 years after the operation.

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