Abstract
BackgroundAlthough the high offset Tri-Lock bone preservation stem (BPS) was used widely, few studies explored the clinical and radiological results. The purpose of this study was to determine the clinical and radiological results of high offset Tri-Lock BPS in unilateral primary total hip arthroplasty (THA) at a minimum follow-up of 3 years.Methods55 patients who underwent cementless THA with high offset Tri-lock BPS from 2017 to 2018 were followed for a minimum follow-up of 3 years. Patients were assessed clinically for complications, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Hip Score (OHS). Femoral offset (FO), acetabular offset (AO), hip offset (HO), HO difference, and leg length discrepancy (LLD) were measured on the anteroposterior (AP) pelvic radiograph. Standard pelvic AP and lateral radiographs were used to evaluate for evidence of bone ingrowth, stem subsidence, stem alignment, radiolucent line around the stem, osteolysis, loosening, ectopic ossification, and femoral stress shielding.ResultsNo patients reported complications during hospitalization nor the follow-up period. At a mean follow-up of 42.5 months, the mean HHS, WOMAC, and OHS scores showed a significant improvement from preoperative to the latest follow-up. No patients reported thigh pain. No revision nor sign of radiographic loosening had been detected. The high offset Tri-Lock BPS significantly improved the FO and HO postoperatively. HO difference and LLD were balanced postoperatively. No sign of stem subsidence, radiolucent line, osteolysis, loosening, ectopic ossification, nor severe stress shielding (more than grade 3–4) were observed at the latest follow-up.ConclusionThe high offset Tri-Lock BPS demonstrated excellent clinical and radiographic outcomes at a minimum follow-up of 3 years. HO difference and LLD between legs decreased significantly and achieved balance postoperatively. Long-term follow-up is required for a definitive conclusion.
Highlights
Total hip arthroplasty (THA) is an effective method to treat end-stage hip disease for relieving the pain and improving joint activity and the quality of life [1, 2]
BMI, body mass index; OA, Osteoarthritis; DDH, dysplasia of the hip; ONFH, osteonecrosis of the femoral head contraindication; (2) patients using high offset Tri-lock bone preservation stem (BPS) (Depuy, Johnson & Johnson, Warsaw, IN, USA) in the total hip arthroplasty (THA) surgery; (3) patients had enough radiological and clinical data; (4) patients had a contralateral native hip; The exclusion criterion was as follows: (1) patients with one-stage bilateral THA; (2) patients who were diagnosed as dysplasia of the hip (DDH) Crowe type III or IV; (3) patients who had disqualified or incomplete radiological data; (4) patients who were lost to follow up; (5) patients had a contralateral hip with prosthesis or deformity
Study population This retrospective study was approved by the clinical trials and biomedical ethics committee of West China Hospital and written informed consents were obtained from all the participants
Summary
Total hip arthroplasty (THA) is an effective method to treat end-stage hip disease for relieving the pain and improving joint activity and the quality of life [1, 2]. The conventional standard-length femoral stem is a common prosthesis and associated with a high survival rate at a follow-up of nearly 30 years [3,4,5]. THA surgery in younger patients is increasing in recent years [6, 7]. The conventional standard-length femoral stem may increase the difficulty of revision surgery due to osseointegration and deficiencies in the preservation of the moral bone stock [11, 12]. The high offset Tri-Lock bone preservation stem (BPS) was used widely, few studies explored the clinical and radiological results. The purpose of this study was to determine the clinical and radiological results of high offset Tri-Lock BPS in unilateral primary total hip arthroplasty (THA) at a minimum follow-up of 3 years
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