Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations
Background: Fit-and-fill stems are known to have excellent outcomes; however, severe stress shielding has been reported in Japanese populations. Short fit-and-fill stems were modified for Asians; however, there have been no previous reports of its outcome. In this study, we compared the 5-year (mean...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344122000930 |
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| author | Suguru Kato, MD Masahiko Nozawa, PhD Sungon Kim, PhD Yuko Sakamoto, PhD Hironori Ochi, PhD Muneaki Ishijima, PhD |
| author_facet | Suguru Kato, MD Masahiko Nozawa, PhD Sungon Kim, PhD Yuko Sakamoto, PhD Hironori Ochi, PhD Muneaki Ishijima, PhD |
| author_sort | Suguru Kato, MD |
| collection | DOAJ |
| description | Background: Fit-and-fill stems are known to have excellent outcomes; however, severe stress shielding has been reported in Japanese populations. Short fit-and-fill stems were modified for Asians; however, there have been no previous reports of its outcome. In this study, we compared the 5-year (mean 68-month) outcomes of 2 fit-and-fill stems with different lengths (standard or short). Material and methods: We reviewed 100 total hip arthroplasties in each standard- or short-stem group. Radiographs were evaluated for femoral morphology, stress shielding, bone remodeling, and fixation. Clinical evaluation was performed using the Japanese Orthopaedic Association (JOA) scores. Results: There was no difference in the degree of stress shielding between the 2 groups. Significant differences were observed in radiolucent lines in zone 4 (P = .005) and cortical hypertrophy in zone 3 (P < .0001) and 5 (P = .048) between the 2 groups. The canal flare index (P < .0003), cortical index (P < .0003), height (P < .0345), and stem size (P < .0081) individually affected stress shielding in the standard-stem group. In contrast, the cortical index (P < .0107) was the only relative factor in the short-stem group. All stems were judged to have bone ingrowth. The JOA score improved significantly (P < .0001); however, there were no significant differences between the 2 groups. Conclusion: The outcomes of both standard and short fit-and-fill stems were favorable. There were no significant differences in the stress shielding or JOA scores. Although there were a few differences in bone remodeling and factors affecting stress shielding, stem length reduction has been achieved without adverse effects with the Japanese femur. |
| first_indexed | 2024-12-12T09:58:43Z |
| format | Article |
| id | doaj.art-e7aafa4ff9cd4da7afd8a029d48c2da3 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-12T09:58:43Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-e7aafa4ff9cd4da7afd8a029d48c2da32022-12-22T00:28:03ZengElsevierArthroplasty Today2352-34412022-06-0115108114Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese PopulationsSuguru Kato, MD0Masahiko Nozawa, PhD1Sungon Kim, PhD2Yuko Sakamoto, PhD3Hironori Ochi, PhD4Muneaki Ishijima, PhD5Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan; Corresponding author. Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, Japan. Tel.: +81 3 5923 3111.Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, JapanDepartment of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, JapanDepartment of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, JapanDepartment of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, JapanDepartment of Orthopaedic Surgery, Juntendo University, Tokyo, JapanBackground: Fit-and-fill stems are known to have excellent outcomes; however, severe stress shielding has been reported in Japanese populations. Short fit-and-fill stems were modified for Asians; however, there have been no previous reports of its outcome. In this study, we compared the 5-year (mean 68-month) outcomes of 2 fit-and-fill stems with different lengths (standard or short). Material and methods: We reviewed 100 total hip arthroplasties in each standard- or short-stem group. Radiographs were evaluated for femoral morphology, stress shielding, bone remodeling, and fixation. Clinical evaluation was performed using the Japanese Orthopaedic Association (JOA) scores. Results: There was no difference in the degree of stress shielding between the 2 groups. Significant differences were observed in radiolucent lines in zone 4 (P = .005) and cortical hypertrophy in zone 3 (P < .0001) and 5 (P = .048) between the 2 groups. The canal flare index (P < .0003), cortical index (P < .0003), height (P < .0345), and stem size (P < .0081) individually affected stress shielding in the standard-stem group. In contrast, the cortical index (P < .0107) was the only relative factor in the short-stem group. All stems were judged to have bone ingrowth. The JOA score improved significantly (P < .0001); however, there were no significant differences between the 2 groups. Conclusion: The outcomes of both standard and short fit-and-fill stems were favorable. There were no significant differences in the stress shielding or JOA scores. Although there were a few differences in bone remodeling and factors affecting stress shielding, stem length reduction has been achieved without adverse effects with the Japanese femur.http://www.sciencedirect.com/science/article/pii/S2352344122000930Total hip arthroplastyFit-and-fill stemsCementless stemStress shieldingJapanese Orthopedic Association score |
| spellingShingle | Suguru Kato, MD Masahiko Nozawa, PhD Sungon Kim, PhD Yuko Sakamoto, PhD Hironori Ochi, PhD Muneaki Ishijima, PhD Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations Arthroplasty Today Total hip arthroplasty Fit-and-fill stems Cementless stem Stress shielding Japanese Orthopedic Association score |
| title | Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations |
| title_full | Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations |
| title_fullStr | Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations |
| title_full_unstemmed | Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations |
| title_short | Comparison of the 5-Year Outcomes Between Standard and Short Fit-and-Fill Stems in Japanese Populations |
| title_sort | comparison of the 5 year outcomes between standard and short fit and fill stems in japanese populations |
| topic | Total hip arthroplasty Fit-and-fill stems Cementless stem Stress shielding Japanese Orthopedic Association score |
| url | http://www.sciencedirect.com/science/article/pii/S2352344122000930 |
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