Dysplasia; Hip, Prosthesis Survival
Conditions
Brief summary
A retrospective consecutive population of patients treated with conical tapered stems in cementless total hip arthroplasty for osteoarthritis due to congenital hip pathologies will be selected. The aim of this retrospective study is to evaluate the long-term clinical and radiographic results of this implant and the survival rates in such a specific cohort.
Detailed description
Congenital hip pathologies may severely alter the local anatomy of the hip, making total hip arthroplasty (THA) due to osteoarthritis after congenital hip pathologies challenging. While it seems that congenital hip pathologies did not significantly influence the outcomes when compared to THA after osteoarthritis, the choice of implant was demonstrated to impact the survival rates of the THA after congenital hip pathologies. To date, no guidelines exist about the correct choice of hip implant in congenital hip pathologies: only mid-term case series are available. Conical tapered stems have been frequently suggested for the most difficult cases. The aim of this study is to describe the survival rates and the long-term clinical and radiological outcome of conical tapered stems in THAs after congenital hip pathologies.
Interventions
DEVICEConical tapered stem
Implantation of conical tapered stem
Sponsors
Istituto Ortopedico Rizzoli
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Symptomatic hip osteoarthritis due to congenital hip pathologies * Consecutive population with a minimum follow-up of 2 years * Cementless total hip arthroplasty with conical tapered stem * Pre-operative planning using CT * Complete clinical and radiographic assessment
Exclusion criteria
* Other type of hip osteoarthritis * Other type of implants * Inadequate pre-operative planning (eg: no CT) * Incomplete clinical and radiographic assessment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Harris Hip Score | 15 months | Mean clinical results at last follow-up evaluated using the Harris hip score. Minimum-maximum values: 0-100. Best result: 100. |
| Survival Rate | 15 months | Percentage of survived implants (no component exchange or removed) described using Kaplan-Meier curve with 95% confidence interval. Minimum-maximum values: 0-100. Best result: 100. |
| Radiographic Cup Osseointegration | 15 months | Osseointegrated cups described using the Moore's criteria: the cup is osseointegrated when at least 3 criteria are present (radial trabeculae, superolateral buttress, inferolateral buttress, medial stress shielding, absence of radiolucent lines). |
| Radiographic Stem Osseointegration | 15 months | Osseointegrated stems described according to Engh's criteria |
Countries
Italy
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Congenital Hip Pathologies Conical tapered stem for osteoarthritis due to congenital hip pathologies
Conical tapered stem: Implantation of conical tapered stem | 85 |
| Congenital Hip Pathologies Conical tapered stem for osteoarthritis due to congenital hip pathologies
Conical tapered stem: Implantation of conical tapered stem | 100 |
| Total | 185 |
Baseline characteristics
| Characteristic | Congenital Hip Pathologies |
|---|---|
| Age, Continuous | 50.9 years STANDARD_DEVIATION 11.5 |
| Crowe I | 46 hip |
| Crowe II | 30 hip |
| Crowe III | 14 hip |
| Crowe IV | 10 hip |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 85 Participants |
| Region of Enrollment Italy | 85 participants |
| Sex: Female, Male Female | 64 Participants |
| Sex: Female, Male Male | 21 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 4 / 85 |
| other Total, other adverse events | 0 / 85 |
| serious Total, serious adverse events | 0 / 85 |
Outcome results
Primary
Harris Hip Score
Mean clinical results at last follow-up evaluated using the Harris hip score. Minimum-maximum values: 0-100. Best result: 100.
Time frame: 15 months
Population: Total hip arthroplasties with a Wagner Cone implant in dysplasia
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Congenital Hip Pathologies | Harris Hip Score | 89.8 points | Standard Deviation 6.8 |
Primary
Radiographic Cup Osseointegration
Osseointegrated cups described using the Moore's criteria: the cup is osseointegrated when at least 3 criteria are present (radial trabeculae, superolateral buttress, inferolateral buttress, medial stress shielding, absence of radiolucent lines).
Time frame: 15 months
Population: Total hip arthroplasties with a Wagner Cone implant in dysplasia
| Arm | Measure | Value (COUNT_OF_UNITS) |
|---|---|---|
| Congenital Hip Pathologies | Radiographic Cup Osseointegration | 98 hip |
Primary
Radiographic Stem Osseointegration
Osseointegrated stems described according to Engh's criteria
Time frame: 15 months
Population: Total hip arthroplasties with a Wagner Cone implant in dysplasia
| Arm | Measure | Value (COUNT_OF_UNITS) |
|---|---|---|
| Congenital Hip Pathologies | Radiographic Stem Osseointegration | 99 hip |
Primary
Survival Rate
Percentage of survived implants (no component exchange or removed) described using Kaplan-Meier curve with 95% confidence interval. Minimum-maximum values: 0-100. Best result: 100.
Time frame: 15 months
Population: Total hip arthroplasties with a Wagner Cone implant in dysplasia
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Congenital Hip Pathologies | Survival Rate | 98.9 percentage of surviving hips |