Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2012 Aug;47(4):286-292. Korean.
    Published online Aug 27, 2012.
    https://doi.org/10.4055/jkoa.2012.47.4.286
    Copyright © 2012 by The Korean Orthopaedic Association
    Original Article

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

    Pil Whan Yoon, M.D., Hyeon Jang Jeong, M.D., Ji-Ho Lee, M.D., Seung-Baik Kang, M.D., Jae Hyup Lee, M.D., Chris H. Jo, M.D., Hyuk Soo Han, M.D., Seung Hwan Rhee, M.D., Jihyeung Kim, M.D. and Kang Sup Yoon, M.D.
      • Department of Orthopaedic Surgery, Seoul National University Boramae Hospital, Seoul, Korea.
    • Correspondence to: Kang Sup Yoon, M.D. Department of Orthopaedic Surgery, Seoul National University Boramae Hospital, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 156-707, Korea. TEL: +82-2-870-2311, FAX: +82-2-831-2826, Email: ksyoon@brm.co.kr
    Received March 21, 2012; Revised April 10, 2012; Accepted May 02, 2012.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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.

    Keywords
    hip; total hip replacement; alumina ceramic; prosthesis

    Figures

    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.

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

    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.

    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.

    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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    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
    Metrics
    Share
    Figures
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