MID-TERM EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY WITH COLLUM FEMORIS PRESERVING PROSTHESIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Mingqing , HU Yihe , LI Kanghua , LIAO Qiande , WEN Ting , ZHONG Da.

Department of Orthopedics, Xiangya Hospital, Central South University, Changsha Hunan, 410008, P.R.China. Corresponding author: HU Yihe, E-mail: Doctorhuyihe19641022@yahoo.com.cn;

Corresponding author：

Keywords：

Total hip arthroplasty; Collum femoris preserving prosthesis; Mid-term effectiveness

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Objective?To discuss the clinical application of total hip arthroplasty (THA) with collum femoris preserving (CFP) prosthesis and to analyze the mid-term effectiveness.?Methods?Between January 2004 and February 2007, 45 patients (48 hips) underwent THA with CFP prosthesis. There were 29 males (31 hips) and 16 females (17 hips) with an average age of 48.8 years (range, 38-60 years), including 20 left hips, 22 right hips, and 3 bilateral hips. The causes of hip replacement were osteoarthritis (20 cases), avascular necrosis of femoral head (13 cases), dysplasia (4 cases), rheumatoid arthritis (3 cases), post-traumatic osteoarthritis (2 cases), ankylosing spondylitis (2 cases), and Perths disease (1 case). The average disease duration was 6.1 years (range, 2-13 years). Harris scores, visual analogue scale (VAS) score, and the hip range of motion (ROM) were recorded at pre- and post-operation. The X-ray films were taken at pre- and post-operation to observe the position, loosening of the prosthesis, and ectopic ossification. The gait of patients were also evaluated during follow-up. Short-form 36 health survey scale (SF-36) was used to evaluate the life quality of patients.?Results?All 45 patients were followed up 5-8 years with an average of 6.4 years. All the incisions healed by first intention. No infection, hip dislocation, nerve injury, or deep vein thrombosis occurred. Six cleavage fractures (13.3%) of the lateral femoral diaphysis at the distal prosthesis occurred during operation, which healed at 8 months postoperatively without any treatment. Mild ectopic ossification occurred in 4 patients (8.9%) who had no discomfort. Five patients (11.1%) had bone mineral density loss in the region of the proximal femur. The survival rates of the cups and stems were all 100% at last follow-up. The results of Harris score, VAS score, and ROM of the hip joint at 1 year postoperatively and last follow-up were significantly better than preoperative ones (P lt; 0.05). No significant difference was found in VAS score and ROM of the hip joint between at 1 year postoperatively and at last follow-up (P gt; 0.05) except the Harris score (P lt; 0.05). According to Harris functional assessment at last follow-up, the results were excellent in 31 hips, good in 11 hips, and fair in 6 hips with an excellent and good rate of 87.5%. The physiological role, body pain, and total health scores were significantly lower than the reference value of urban men from Sichuan province (P lt; 0.05), but no significant difference was found in the other scores of the SF-36 when compared with the reference value (P gt; 0.05).?Conclusion?THA with CFP prosthesis is a good option for the young patient with complete collum femoris and without osteoporosis, and can achieve good mid-term effectiveness.

Citation： LI Mingqing,HU Yihe,LI Kanghua,LIAO Qiande,WEN Ting,ZHONG Da.. MID-TERM EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY WITH COLLUM FEMORIS PRESERVING PROSTHESIS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(8): 897-901. doi: Copy

1.	Pipino F, Molfetta L. Femoral neck preservation in total hip replacement. Ital J Orthop Traumatol, 1993, 19(1): 5-12.
2.	Pons M. Learning curve and short-term results with a short-stem CFP system. Hip Int, 2010, 20 (Suppl 7): 52-57.
3.	Briem D, Schneider M, Bogner N, et al. Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop, 2011, 35(5): 655-660.
4.	Nowak M, Nowak TE, Schmidt R, et al. Prospective study of a cementless total hip arthroplasty with a collum femoris preserving stem and a trabeculae oriented pressfit cup: minimun 6-year follow-up. Arch Orthop Trauma Surg, 2011, 131(4): 549-555.
5.	Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
6.	李宁秀, 刘朝杰, 李俊, 等. 四川省城乡居民SF-36评价参考值. 华西医科大学学报, 2001, 32(1): 43-47.
7.	Mäkelä KT, Eskelinen A, Pulkkinen P, et al. Results of 3, 668 primary total hip replacements for primary osteoarthritis in patients under the age of 55 years. Acta Orthop, 2011, 82(5): 521-529.
8.	Kinov P, Radl R, Zacherl M, et al. Correlation between thigh pain and radiological findings with a proximally porous-coated stem. Acta Orthop Belg, 2007, 73(5): 618-624.
9.	Callary SA, Campbell DG, Mercer GE, et al. The 6-year migration characteristics of a hydroxyapatite-coated femoral stem a radiostereometric analysis study. J Arthroplasty, 2012, 27(7): 1344-1348.
10.	Chambers B, St Clair SF, Froimson MI. Hydroxyapatite-coated tapered cementless femoral components in total hip arthroplasty. J Arthroplasty, 2007, 22(4 Suppl 1): 71-74.
11.	Chen HH, Morrey BF, An KN, et al. Bone remodeling characteristics of a short-stemmed total hip replacement. J Arthroplasty, 2009, 24(6): 945-950.
12.	Gillies RM, Kohan L, Cordingley R. Periprosthetic bone remodelling of a collum femoris preserving cementless titanium femoral hip replacement. Comput Methods Biomech Biomed Engin, 2007, 10(2): 97- 102.
13.	Hayashi S, Nishiyama T, Fujishiro T, et al. Periprosthetic bone mineral density with a cementless triple tapered stem is dependent on daily activity. Int Orthop, 2012, 36(6): 1137-1142.
14.	Davidson D, Pike J, Garbuz D, et al. Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Joint Surg (Am), 2008, 90(9): 2000-2012.
15.	Thomsen MN, Jakubowitz E, Seeger JB, et al. Fracture load for periprosthetic femoral fractures in cemented versus uncemented hip stems: an experimental in vitro study. Orthopedics, 2008, 31(7): 653.
16.	Jakubowitz E, Seeger JB, Lee C, et al. Do short-stemmed- prostheses induce periprosthetic fractures earlier than standard hip stems? A biomechanical ex-vivo study of two different stem designs. Arch Orthop Trauma Surg, 2009, 129(6): 849-855.
17.	Rama KR, Vendittoli PA, Ganapathi M, et al. Heterotopic ossification after surface replacement arthroplasty and total hip arthroplasty: a randomized study. J Arthroplasty, 2009, 24(2): 256-262.
18.	Ritter MA, Galley M. Heterotopic bone formation following resurfacing total hip arthroplasty. HSS J, 2011, 7(1): 41-43.

1. Pipino F, Molfetta L. Femoral neck preservation in total hip replacement. Ital J Orthop Traumatol, 1993, 19(1): 5-12.
2. Pons M. Learning curve and short-term results with a short-stem CFP system. Hip Int, 2010, 20 (Suppl 7): 52-57.
3. Briem D, Schneider M, Bogner N, et al. Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop, 2011, 35(5): 655-660.
4. Nowak M, Nowak TE, Schmidt R, et al. Prospective study of a cementless total hip arthroplasty with a collum femoris preserving stem and a trabeculae oriented pressfit cup: minimun 6-year follow-up. Arch Orthop Trauma Surg, 2011, 131(4): 549-555.
5. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
6. 李宁秀, 刘朝杰, 李俊, 等. 四川省城乡居民SF-36评价参考值. 华西医科大学学报, 2001, 32(1): 43-47.
7. Mäkelä KT, Eskelinen A, Pulkkinen P, et al. Results of 3, 668 primary total hip replacements for primary osteoarthritis in patients under the age of 55 years. Acta Orthop, 2011, 82(5): 521-529.
8. Kinov P, Radl R, Zacherl M, et al. Correlation between thigh pain and radiological findings with a proximally porous-coated stem. Acta Orthop Belg, 2007, 73(5): 618-624.
9. Callary SA, Campbell DG, Mercer GE, et al. The 6-year migration characteristics of a hydroxyapatite-coated femoral stem a radiostereometric analysis study. J Arthroplasty, 2012, 27(7): 1344-1348.
10. Chambers B, St Clair SF, Froimson MI. Hydroxyapatite-coated tapered cementless femoral components in total hip arthroplasty. J Arthroplasty, 2007, 22(4 Suppl 1): 71-74.
11. Chen HH, Morrey BF, An KN, et al. Bone remodeling characteristics of a short-stemmed total hip replacement. J Arthroplasty, 2009, 24(6): 945-950.
12. Gillies RM, Kohan L, Cordingley R. Periprosthetic bone remodelling of a collum femoris preserving cementless titanium femoral hip replacement. Comput Methods Biomech Biomed Engin, 2007, 10(2): 97- 102.
13. Hayashi S, Nishiyama T, Fujishiro T, et al. Periprosthetic bone mineral density with a cementless triple tapered stem is dependent on daily activity. Int Orthop, 2012, 36(6): 1137-1142.
14. Davidson D, Pike J, Garbuz D, et al. Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Joint Surg (Am), 2008, 90(9): 2000-2012.
15. Thomsen MN, Jakubowitz E, Seeger JB, et al. Fracture load for periprosthetic femoral fractures in cemented versus uncemented hip stems: an experimental in vitro study. Orthopedics, 2008, 31(7): 653.
16. Jakubowitz E, Seeger JB, Lee C, et al. Do short-stemmed- prostheses induce periprosthetic fractures earlier than standard hip stems? A biomechanical ex-vivo study of two different stem designs. Arch Orthop Trauma Surg, 2009, 129(6): 849-855.
17. Rama KR, Vendittoli PA, Ganapathi M, et al. Heterotopic ossification after surface replacement arthroplasty and total hip arthroplasty: a randomized study. J Arthroplasty, 2009, 24(2): 256-262.
18. Ritter MA, Galley M. Heterotopic bone formation following resurfacing total hip arthroplasty. HSS J, 2011, 7(1): 41-43.

Chinese Journal of Reparative and Reconstructive Surgery

MID-TERM EFFECTIVENESS OF TOTAL HIP ARTHROPLASTY WITH COLLUM FEMORIS PRESERVING PROSTHESIS

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