title: Metaphyseal-loading anterolaterally-flared femoral stem in cementless total hip arthroplasty: five- to eleven-year follow-up evaluation.
abstract: Using a nonlinear three-dimensional finite element analysis simulating loading conditions, we designed a new type of proximal-fitting, anterolaterally-flared, arc-deposit hydroxyapatite-coated anatomical femoral stem (FMS-anatomic stem; Japan Medical Materials, Osaka, Japan) for cementless total hip arthroplasty (THA) for Japanese patients with dysplastic hip osteoarthritis. The aim of the present study was to analyze the clinical and radiographic outcomes of the new stem. We reviewed 143 consecutive patients (164 hips; 13 men, 14 hips; 130 women, 150 hips; age at surgery, 56.6 +/- 7.6 years, mean +/- SD, range, 30-74) who underwent cementless THA using the FMS-anatomic stem at a single institution, with a follow-up period of 7.6 +/- 1.6 years (range, 5.3-11.0). Harris Hip score improved from 46.1 +/- 12.6 before surgery to 90.0 +/- 8.9 points post-THA. The 7.6-year survival rate of the stem was 99.0% after revision for aseptic loosening. Radiographs at follow-up confirmed the stability of the femoral stems within the femoral canal in all cases, with sufficient bone ingrowth. None of the patients had subsidence of the stem exceeding 2.0 mm within the femoral canal or changes in varus or valgus position of more than 2.0 degrees . The FMS-anatomic stem provided excellent results in patients with dysplastic hip osteoarthritis. Our analysis confirmed reduced radiolucency around the stem in Gruen zones, minimal subsidence, appropriate stress shielding, and promising medium-term stability within the femoral canal in our patients.
authors.affiliation: Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, The University of Fukui, Matsuoka Shimoaizuki 23, Eiheiji, Fukui, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kawahara
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kokubo
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yayama
authors.forename: Kenzo
authors.initials: K
authors.lastname: Uchida
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Hisashi
authors.initials: H
authors.lastname: Oki
authors.forename: Kohei
authors.initials: K
authors.lastname: Negoro
authors.forename: Erisa S
authors.initials: ES
authors.lastname: Mwaka
authors.forename: Norbert T
authors.initials: NT
authors.lastname: Orwotho
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Baba
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography