Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 1;59(5):e752-e757.
doi: 10.1055/s-0044-1787770. eCollection 2024 Oct.

A Retrospective Cohort Study of the Effects of Canal Filling Ratio and Femoral Bone Density Change on the Outcomes of Anatomical and Double-tapered Wedge Stems

Thakrit Chompoosang  1 , Patcharavit Ploynumpon  1
Affiliations

A Retrospective Cohort Study of the Effects of Canal Filling Ratio and Femoral Bone Density Change on the Outcomes of Anatomical and Double-tapered Wedge Stems

Thakrit Chompoosang et al. Rev Bras Ortop (Sao Paulo). .

Abstract

Objective This study aims to compare the proximal femoral bone density changes in follow-up X-ray imaging and the proximal filling ratios of stems between anatomical and double-tapered wedge stem designs. Methods Patients aged between 18 and 80 years who received primary total hip arthroplasty using both types of stems between 2017 and 2019 and had follow-up tests for up to a year were included in the study. Canal filling ratios at 3 levels (lesser trochanter [LT], 2 cm above LT, and 7 cm below LT) using the optimal densitometry method. Femoral bone density changes were measured using the Gruen zoning method. Results A total of 92 patients (76% female and 24% male) met the inclusion criteria for this study. The mean age was 53.86 ± 13.00 years. The canal filling ratio in the double-tapered wedge group (Accolade II) was significantly higher than that in the anatomical stem group (ABGII) ( p < 0.001, p < 0.001, and p = 0.013) for all levels of measurement. No significant difference was observed between both types of stems in femoral bone density changes in zones 1 and 4. However, there were significant differences in femoral bone change, with bone loss being higher in the anatomical stem group in zone 7 (-25% versus -17%; p = 0.010). Conclusion Double-tapered wedge stem had a significantly higher canal filling ratio than the anatomical stem at all levels but had less femoral bone density loss in the follow-up postoperative imaging in zone 7. Furthermore, in zones 1 and 4, there was no significant difference in femoral bone density loss.

Keywords: bone remodeling; femur; hip prosthesis; prosthesis design.

PubMed Disclaimer

Conflict of interest statement

Conflito de Interesses Os autores não têm conflito de interesses a declarar.

Figures

Fig. 1
Fig. 1
Measurement of canal filling ratios at the lesser trochanter (LT), 2 cm proximal to LT, and 6 cm distal to LT.
Fig. 2
Fig. 2
Measurement of the proximal femoral bone density using optimal densitometry method.
Fig. 3
Fig. 3
Comparison of the proximal femoral bone density changes in the Gruen zone 7 of both stems (A, anatomical stem; B, double-tapered wedge stem).
Fig. 4
Fig. 4
Comparison of the proximal femoral bone density changes in the Gruen zone 1 of both stems (A, anatomical stem; B, double-tapered wedge stem).
Fig. 5
Fig. 5
Comparison of the proximal femoral bone density changes in the Gruen zone 4 of both stems (A, anatomical stem; B, double-tapered wedge stem).
Fig. 1
Fig. 1
Medida das taxas de preenchimento do canal no trocânter menor (TM), 2 cm proximal ao TM e 6 cm distal ao TM.
Fig. 2
Fig. 2
Medida da densidade óssea femoral proximal pelo método de densitometria ideal.
Fig. 3
Fig. 3
Comparação das alterações da densidade óssea femoral proximal na zona de Gruen 7 de ambas hastes (A, haste anatômica; B, haste cônica em cunha dupla).
Fig. 4
Fig. 4
Comparação das alterações da densidade óssea femoral proximal na zona de Gruen 1 de ambas hastes (A, haste anatômica; B, haste cônica em cunha dupla).
Fig. 5
Fig. 5
Comparação das alterações da densidade óssea femoral proximal na zona de Gruen 4 de ambas hastes (A, haste anatômica; B, haste cônica em cunha dupla).
See this image and copyright information in PMC

References

    1. van der Wal B C, de Kramer B J, Grimm B, Vencken W, Heyligers I C, Tonino A J. Femoral fit in ABG-II hip stems, influence on clinical outcome and bone remodeling: a radiographic study. Arch Orthop Trauma Surg. 2008;128(10):1065–1072. - PubMed
    1. Herrera A, Canales V, Anderson J, García-Araujo C, Murcia-Mazón A, Tonino A J. Seven to 10 years followup of an anatomic hip prosthesis: an international study. Clin Orthop Relat Res. 2004;(423):129–137. - PubMed
    1. Panisello J J, Canales V, Herrero L, Herrera A, Mateo J, Caballero M J. Changes in periprosthetic bone remodelling after redesigning an anatomic cementless stem. Int Orthop. 2009;33(02):373–379. - PMC - PubMed
    1. de Boer F A, Sariali E. Comparison of anatomic vs. straight femoral stem design in total hip replacement - femoral canal fill in vivo. Hip Int. 2017;27(03):241–244. - PubMed
    1. Laine H J, Puolakka T J, Moilanen T, Pajamäki K J, Wirta J, Lehto M U. The effects of cementless femoral stem shape and proximal surface texture on ‘fit-and-fill’ characteristics and on bone remodeling. Int Orthop. 2000;24(04):184–190. - PMC - PubMed

LinkOut - more resources