Total hip arthroplasty in patients with deficient bone stock and small femoral canals

• Published in: The Journal of arthroplasty 2003-01, Vol.18 (1), p.35-40
• Main Authors: Cameron, H.U., Lee, O.B., Chou†, H.
• Format: Article
• Language: English
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - surgery; Adolescent; Adult; Aged; Arthroplasty, Replacement, Hip - methods; congenital dislocation hip; developmental dysplasia hip; Female; Femur - diagnostic imaging; Femur - surgery; Hip Prosthesis; Humans; Male; Middle Aged; mini-hips; Polyethylenes; Postoperative Complications; Prosthesis Failure; Radiography; Reoperation; small hips; Treatment Outcome
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1054/arth.2003.50022

Total hip arthroplasty in patients requiring very small femoral stems is a challenge because frequently deformity and inadequate bone stock, especially of the acetabulum, are also present. An analysis of 34 consecutive cases managed with a 9-mm distal diameter noncemented stem was performed. The mean patient age was 42.6 years and mean follow-up time was 7.8 years. Two patients were lost to follow-up at 4 and 6 years, and 1 patient had a fracture below the stem immediately after surgery, necessitating revision. These patients were excluded from analysis. Of the remaining 31 patients, 1 underwent revision for distal osteolysis leading to fracture. The Harris hip ratings for these patients were 58.1% excellent, 22.6% good, 16.1% fair, and 3.2% poor. Complications experienced included 1 femoral component that fractured but remains asymptomatic. Polyethylene wear of the very small acetabular components in 31% of cases is a cause for concern; 2 of these patients have required revision for this reason. The acetabular component was subsequently modified to allow thicker polyethylene. Copyright 2003, Elsevier Science (USA). All rights reserved.