Clinical Results of Minimally Invasive Total Hip Arthroplasty Using a Taper-lock Stem Prosthesis with a Changeable Neck

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  • FUJITA Yoshinari
    Department of Orthopaedic Surgery, School of Medicine, Keio University
  • 藤中 太郎
    Department of Orthopaedic Surgery, School of Medicine, Keio University
  • 大久保 匡
    Department of Orthopaedic Surgery, School of Medicine, Keio University
  • 船山 敦
    Department of Orthopaedic Surgery, School of Medicine, Keio University
  • 戸山 芳昭
    Department of Orthopaedic Surgery, School of Medicine, Keio University

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Other Title
  • Changeableネック構造のTaper Lock型ステムを用いた人工股関節置換術の臨床成績
  • Changeable ネック コウゾウ ノ Taper Lockガタ ステム オ モチイタ ジンコウ コ カンセツ チカンジュツ ノ リンショウ セイセキ

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Abstract

Objective: The objective of this study was to assess the usefulness of a taper-lock stem prosthesis with a changeable neck for the adjustment of leg-length discrepancy (LLD) and offset of the femoral neck. <br>Methods: Twenty patients underwent 23 primary total hip arthroplasties with a taper-lock stem prosthesis with a changeable neck (Kinectiv, Zimmer). The original diseases were osteoarthritis in 16 cases, avascular necrosis of the femoral head in 4, rheumatoid arthritis in 4, and rapidly destructive coxopathy in 1. The modified Watson-Jones approach was used in all cases. The mean age at the time of operation was 72 years, and the mean follow-up period was 6 months. The control group underwent 21 arthroplasties performed with a non-modular neck taper-lock stem prosthesis (Accolade TMZF, Stryker). The LLD and the offset of the femoral neck were measured. <br>Results: The JOA hip score improved from 47.2 points preoperatively to 84.9 points at the final follow-up. Perioperative complications included one fissure fracture of the proximal femur and one case of peroneal nerve palsy, but there was no postoperative dislocation. Only seven neck variations without version-controlled type were used in this series, although there were 60 options available. The mean inclination angle of the acetabular sockets was 38.7° and the mean anteversion angle was 15.4°. All cases were within Lewinneks safe zone. The mean preoperative LLD was 8.6±6.3 mm, but the postoperative LLD was adjusted to 4.0±2.7 mm. The preoperative offset ratio of the femoral neck to the unaffected side was 0.95±0.12, but the postoperative offset ratio was adjusted to 1.025±0.05. No significant difference was found in the adjustment of LLD or femoral neck ratio between the two groups.<br>Conclusion: The short-term clinical results of total hip arthroplasty using a taper-lock stem prosthesis with a changeable neck were excellent. Adjustment of the LLD and the offset of the femoral neck were accurately obtained, but there was no significant difference between the two groups.

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