Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Aug;26(6):591-8.
doi: 10.1007/s00590-016-1796-5. Epub 2016 Jun 22.

The Correlation Between Clinical Radiological Outcome and Contact State of Implant and Femur Using Three-Dimensional Templating Software in Cementless Total Hip Arthroplasty

Affiliations

The Correlation Between Clinical Radiological Outcome and Contact State of Implant and Femur Using Three-Dimensional Templating Software in Cementless Total Hip Arthroplasty

Daisuke Inoue et al. Eur J Orthop Surg Traumatol. .

Abstract

Background: Initial fixation is a key factor in the success of cementless THA using a tapered wedge stem. The purpose of this study was to use three-dimensional templating software to examine the correlation between quantitative contact state and important clinical radiological outcomes, specifically stem subsidence, stress shielding, and cortical hypertrophy.

Methods: We conducted a retrospective consecutive review of 75 hips in 70 patients over a minimum 3-year follow-up period. X-rays and CT scans were investigated to assess preoperative planning, quantify the contact state of implant and femur, and assess stem alignment, stem subsidence, stress shielding, and cortical hypertrophy. We evaluated the correlation between radiological outcomes and three-dimensional quantitative contact state according to Gruen Zone in each Dorr classification.

Results: Density mapping indicated that stem subsidence increased postoperatively if the stem had less cortical contact in the middle to distal portion of the implant in terms of initial fixation. Cases having too much cortical contact in the distal portion of the implant tended to have increased stress shielding. We found no correlation between cortical hypertrophy and the contact state of implant and femur.

Conclusions: Density mapping with three-dimensional templating software can be useful in predicting stem subsidence and stress shielding following cementless THA with a tapered wedge stem. Further analysis is required to accurately depict the correlation between cortical hypertrophy and the contact state.

Keywords: Density mapping; Radiological outcome; Three-dimensional templating software; Total hip arthroplasty.

Similar articles

See all similar articles

Cited by 3 articles

References

    1. Clin Orthop Relat Res. 2012 Nov;470(11):3003-6 - PubMed
    1. Clin Orthop Relat Res. 1979 Jun;(141):17-27 - PubMed
    1. J Bone Joint Surg Am. 1979 Jan;61(1):15-23 - PubMed
    1. Int Orthop. 2001;25(4):209-13 - PubMed
    1. J Arthroplasty. 1988;3(2):117-21 - PubMed

MeSH terms

LinkOut - more resources

Feedback