The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty
Abstract Objective To investigate whether the application of a curved rasp on the femoral side is effective in reducing the incidence of stem malalignment in total hip replacement with direct anterior approach (DAA-THA), followed by the analysis of the independent risk factors affecting stem malalig...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06409-7 |
| _version_ | 1797841232116842496 |
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| author | Bei Lin Yiping Lan Zhiming Lu Shiwei Xie Feitai Lin Yan Weng Eryou Feng Jinhua Chen |
| author_facet | Bei Lin Yiping Lan Zhiming Lu Shiwei Xie Feitai Lin Yan Weng Eryou Feng Jinhua Chen |
| author_sort | Bei Lin |
| collection | DOAJ |
| description | Abstract Objective To investigate whether the application of a curved rasp on the femoral side is effective in reducing the incidence of stem malalignment in total hip replacement with direct anterior approach (DAA-THA), followed by the analysis of the independent risk factors affecting stem malalignment. Methods Retrospective analysis was carried out covering 160 patients undergoing DAA-THA from January 2019 to December 2021, with Tri-Lock (BPS, Depuy) stem applied in all 113 patients were screened according to inclusion and exclusion criteria. The data of gender, age, body mass index, preoperative diagnoses, Dorr classification, FAR ratio, pelvic morphology ratio, WOMAC scores, were analyzed to explore the independent factors influencing the malalignment of the femoral prosthesis implantation. Then data of patients were divided into group A and group B according to whether the curved rasp was taken during the operation. The chi-square test was performed to compare the incidence of femoral stem malalignment between the two groups. Results There revealed two independent risk factors: BMI and FAR ratio that affected femoral stem malalignment. The increased BMI was associated with a higher probability of femoral stem malalignment (P<0.05), the probability of malalignment of femoral stem in FAR ratio<1 was 1.15 times higher than that in FAR>1(OR = 1.15, 95% CI: 1.03–1.28, P<0.05). Further grouping analysis showed that the incidence of femoral stem malalignment in patients with intraoperative application of curved rasp was 27%, while in patients without curved rasp, the incidence of femoral stem malalignment increased significantly to 48.7%(P<0.05). The placement angle of prosthesis in group A was significantly better than that in group B, especially mild femoral stem malalignment (0%) and severe femoral stem malalignment (2.70%), and the difference was statistically significant (P < 0.05). There found no significant difference in age, gander, intraoperative complications and last follow-up assessment of WOMAC scores between the two groups of patients. Conclusions In DAA-THA, BMI and FAR ratio act as the independent risk factors for femoral stem malalignment. Intraoperative use of a curved rasp significantly reduces the incidence of malalignment of the femoral stem. |
| first_indexed | 2024-04-09T16:27:42Z |
| format | Article |
| id | doaj.art-9e3dd408517a4926bf9c12c44ab0e5b6 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-09T16:27:42Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-9e3dd408517a4926bf9c12c44ab0e5b62023-04-23T11:03:44ZengBMCBMC Musculoskeletal Disorders1471-24742023-04-0124111210.1186/s12891-023-06409-7The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplastyBei Lin0Yiping Lan1Zhiming Lu2Shiwei Xie3Feitai Lin4Yan Weng5Eryou Feng6Jinhua Chen7Department of Arthrosis Surgery, Fuzhou Second HospitalDepartment of Arthrosis Surgery, Fuzhou Second HospitalDepartment of Arthrosis Surgery, Fuzhou Second HospitalDepartment of Arthrosis Surgery, Fuzhou Second HospitalDepartment of Arthrosis Surgery, Fuzhou Second HospitalDepartment of Arthrosis Surgery, Fuzhou Second HospitalDepartment of Arthrosis Surgery, Fuzhou Second HospitalFollow-Up Center, Fujian Medical University Union HospitalAbstract Objective To investigate whether the application of a curved rasp on the femoral side is effective in reducing the incidence of stem malalignment in total hip replacement with direct anterior approach (DAA-THA), followed by the analysis of the independent risk factors affecting stem malalignment. Methods Retrospective analysis was carried out covering 160 patients undergoing DAA-THA from January 2019 to December 2021, with Tri-Lock (BPS, Depuy) stem applied in all 113 patients were screened according to inclusion and exclusion criteria. The data of gender, age, body mass index, preoperative diagnoses, Dorr classification, FAR ratio, pelvic morphology ratio, WOMAC scores, were analyzed to explore the independent factors influencing the malalignment of the femoral prosthesis implantation. Then data of patients were divided into group A and group B according to whether the curved rasp was taken during the operation. The chi-square test was performed to compare the incidence of femoral stem malalignment between the two groups. Results There revealed two independent risk factors: BMI and FAR ratio that affected femoral stem malalignment. The increased BMI was associated with a higher probability of femoral stem malalignment (P<0.05), the probability of malalignment of femoral stem in FAR ratio<1 was 1.15 times higher than that in FAR>1(OR = 1.15, 95% CI: 1.03–1.28, P<0.05). Further grouping analysis showed that the incidence of femoral stem malalignment in patients with intraoperative application of curved rasp was 27%, while in patients without curved rasp, the incidence of femoral stem malalignment increased significantly to 48.7%(P<0.05). The placement angle of prosthesis in group A was significantly better than that in group B, especially mild femoral stem malalignment (0%) and severe femoral stem malalignment (2.70%), and the difference was statistically significant (P < 0.05). There found no significant difference in age, gander, intraoperative complications and last follow-up assessment of WOMAC scores between the two groups of patients. Conclusions In DAA-THA, BMI and FAR ratio act as the independent risk factors for femoral stem malalignment. Intraoperative use of a curved rasp significantly reduces the incidence of malalignment of the femoral stem.https://doi.org/10.1186/s12891-023-06409-7Total hip arthroplastyTri-Lock (BPS) stemDirect anterior approachProsthesis placement angleRadiological analysisWOMAC score |
| spellingShingle | Bei Lin Yiping Lan Zhiming Lu Shiwei Xie Feitai Lin Yan Weng Eryou Feng Jinhua Chen The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty BMC Musculoskeletal Disorders Total hip arthroplasty Tri-Lock (BPS) stem Direct anterior approach Prosthesis placement angle Radiological analysis WOMAC score |
| title | The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty |
| title_full | The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty |
| title_fullStr | The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty |
| title_full_unstemmed | The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty |
| title_short | The compared study about femoral stem malalignment with or without the special curved rasp during DAA total hip arthroplasty |
| title_sort | compared study about femoral stem malalignment with or without the special curved rasp during daa total hip arthroplasty |
| topic | Total hip arthroplasty Tri-Lock (BPS) stem Direct anterior approach Prosthesis placement angle Radiological analysis WOMAC score |
| url | https://doi.org/10.1186/s12891-023-06409-7 |
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