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Stem design enhancements affect cementless THA results
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Lawrence D. Dorr
ORLANDO, Fla. — Being familiar with more than one hip stem design is critical to successful cementless fixation with total hip arthroplasty (THA), based on information presented here.
“If you look at the most popular stems in Europe … I think the smartest surgeons understand that with the cementless operation they have to adjust the operation to the anatomy, rather than making the anatomy adjust to their operation,” Lawrence D. Dorr, MD, said in his presentation at the Current Concepts in Joint Replacement Winter Meeting, here.
“That means you may need to know two stems because some stems will not fit well in one person’s anatomy and I do not think an exchangeable neck is a good way to adjust that,” he said.
Recently, tapered stems have become more popular. As a result, however, there have been more revisions and re-admissions. Part of the reason for these problems is surgeons not knowing how their stem is implanted, according to Dorr, of Inglewood, Calif.
“One of the reasons the data show this is occurring is because cementless stems change the hip operation. In the traditional operation, the surgeon places the cup and then adjusts the stem to fit the cup,” Dorr said. “In a cementless stem, the stem goes in according to the anatomy of the patient and the shape of the stem, so there is a wide variability in what the stem position is and you must understand what your stem does when it goes into the bone,” he said.
Reference:
Dorr LD. Paper #11. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 12-15, 2012; Orlando, Fla.
Disclosure: Dorr is a stock owner for Total Joint Orthopedics.