Modern proximally tapered uncemented stems can be safely used in Dorr type C femoral bone.
Cementless femoral fixation has become widely accepted in modern total hip arthroplasty. Treating patients who have a stovepipe-shaped femur (Dorr type C) with cementless implants has traditionally been challenging. We treated 53 consecutive patients (60 hips) who had type C bone with identical tapered, proximally coated implants and postoperative weight bearing as tolerated. At 6 weeks, all 60 hips had radiographically documented bony integration, and at 1 year, there was no evidence of fracture, subsidence, thigh pain, stress shielding, loose stems, or risk of failure. Of those patients, 40 (43 hips) had midterm follow-up (average, 6 years; range, 4-9 years); the findings were the same. We conclude that modern proximally tapered stems can be used with early weight bearing in patients with type C bone.
Towson Orthopaedic Associates, Towson, Maryland, USA.
David F
DF
Dalury
Todd C
TC
Kelley
Mary Jo
MJ
Adams
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D005271:Femur Head Necrosis / Q000601:surgery; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology