title: Influence of cementless femoral stems inserted in varus on functional outcome in primary total hip arthroplasty.
abstract: BACKGROUND
  Historically, cemented total hip arthroplasty (THA) femoral stems inserted in varus have yielded poor clinical results. Few studies to date have addressed the question of the effects of varus alignment on cementless stems. We conducted a retrospective review of 125 uncemented THA femoral stems implanted by a single surgeon from 1994 to 1999.
  
  
  METHODS
  We conducted a retrospective radiographic review of 125 cementless primary THA femoral stems implanted by a single surgeon who used the Watson-Jones approach; we identified 16 stems implanted in varus, defined as >or= 5 degrees and thus analyzed the effect of varus alignment on functional outcome. We matched varus stems to a cohort of 16 nonvarus cementless stems and measured radiographic signs of loosening and subsidence, defined as > 2 mm.
  
  
  RESULTS
  At 4 years postsurgery, there was no significant difference in range of motion or in Harris Hip Score (p > 0.5), and no cases showed evidence of radiographic loosening or subsidence (p = 0.226).
  
  
  CONCLUSIONS
  Study results suggest there is no consequence of varus femoral alignment in the cementless stems. Although it is not recommended to implant stems in varus, there were no apparent radiographic or clinical consequences observed at up to 4 years postoperative in this small case series.
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences Henderson Hospital, affiliated with the Faculty of Health Sciences, McMaster University, Hamilton, ON.
authors.forename: Justin
authors.initials: J
authors.lastname: de Beer
authors.forename: Scott
authors.initials: S
authors.lastname: McKenzie
authors.forename: Matthias
authors.initials: M
authors.lastname: Hubmann
authors.forename: Danielle
authors.initials: D
authors.lastname: Petruccelli
authors.forename: Mitchell
authors.initials: M
authors.lastname: Winemaker
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome