Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty
Objective To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA). Study design Retrospective case series. Animals Fifty‐five dogs; 58 THAs. Methods Eighty cobalt‐chromium BFX THAs were reviewed, 58 met...
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| Veröffentlicht in: | Veterinary surgery 2017-08, Vol.46 (6), p.803-811 |
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| creator | Townsend, Sarah Kim, Stanley E. Pozzi, Antonio |
| description | Objective
To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA).
Study design
Retrospective case series.
Animals
Fifty‐five dogs; 58 THAs.
Methods
Eighty cobalt‐chromium BFX THAs were reviewed, 58 met inclusion criteria. Implant size, positioning, and major complications within 12 months of surgery were recorded. Femoral canal flare (FCF), canal fill, stem angle, and subsidence at 3 months were measured from postoperative radiographs. Appropriateness of final stem size was assessed with digital templates. Odds ratios for associations were calculated.
Results
Mean ± SD coronal canal fill (Fillcor) was 75% ± 6, FCF was 2.0 ± 0.3, and subsidence was 1.7 mm ± 2.6. Stem angulation ranged from 7° varus to 6° valgus, and 7° cranial to 3° caudal. Appropriately sized stems (n = 45) had a mean Fillcor of 78%. Major stem complications occurred in 12% of THAs. Femora with subsidence > 3 mm were 45.3 times more likely to develop postoperative stem complications (P = .02). Stems with varus angulation ≥ 5° were 12.5 times more likely to sustain intraoperative fissures (P = .03). Stems considered undersized based on postoperative digital templating were 5.6 times more likely to develop stem complications (P = .04) and 5.7 times more likely to subside > 3 mm (P = .03).
Conclusion
Varus stem angulation should be avoided to prevent fissures. Canal fill is a poor indicator of optimal stem size and the current recommendation of >85% is unnecessarily high. Postoperative templating may be useful for assessing appropriateness of stem size. |
| doi_str_mv | 10.1111/vsu.12666 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1894519748</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1894519748</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3886-7255cb34f35415e5bf40ea0a158bc1bd43aec668758fa8f1adb73f8f5e14387f3</originalsourceid><addsrcrecordid>eNp1kc9u1DAQhy0EokvhwAsgS1zKIa0d_4lzRKtSkCpxgCJuluMds66SOHiclu2JR-AZeRKybOGAxGikkeVPn0bzI-Q5Z6d8qbMbnE95rbV-QFZcibpqFfv8kKwY17wSsm2PyBPEa8ZYK6V4TI5qIzWTdb0i385DAF9oChQLDBTjXRy_UDdu6JQwlphGujRuUy4_v_8okAfq0zD10bv9J9LbWLbUuzGOQKcMiDTEQj0MMJZ-_yypuJ5u40RdLtucpt5h2T0lj4LrEZ7dz2Ny9eb84_ptdfn-4t369WXlhTG6amqlfCdkEEpyBaoLkoFjjivTed5tpHDgtTaNMsGZwN2ma0QwQQGXwjRBHJOTg3fK6esMWOwQ0UPfuxHSjJabVireNtIs6Mt_0Os053HZzvK2lkYp3aiFenWgfE6IGYKdchxc3lnO7D4Ou8Rhf8exsC_ujXM3wOYv-ef-C3B2AG5jD7v_m-ynD1cH5S8ik5d_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1924855675</pqid></control><display><type>article</type><title>Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Townsend, Sarah ; Kim, Stanley E. ; Pozzi, Antonio</creator><creatorcontrib>Townsend, Sarah ; Kim, Stanley E. ; Pozzi, Antonio</creatorcontrib><description>Objective
To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA).
Study design
Retrospective case series.
Animals
Fifty‐five dogs; 58 THAs.
Methods
Eighty cobalt‐chromium BFX THAs were reviewed, 58 met inclusion criteria. Implant size, positioning, and major complications within 12 months of surgery were recorded. Femoral canal flare (FCF), canal fill, stem angle, and subsidence at 3 months were measured from postoperative radiographs. Appropriateness of final stem size was assessed with digital templates. Odds ratios for associations were calculated.
Results
Mean ± SD coronal canal fill (Fillcor) was 75% ± 6, FCF was 2.0 ± 0.3, and subsidence was 1.7 mm ± 2.6. Stem angulation ranged from 7° varus to 6° valgus, and 7° cranial to 3° caudal. Appropriately sized stems (n = 45) had a mean Fillcor of 78%. Major stem complications occurred in 12% of THAs. Femora with subsidence > 3 mm were 45.3 times more likely to develop postoperative stem complications (P = .02). Stems with varus angulation ≥ 5° were 12.5 times more likely to sustain intraoperative fissures (P = .03). Stems considered undersized based on postoperative digital templating were 5.6 times more likely to develop stem complications (P = .04) and 5.7 times more likely to subside > 3 mm (P = .03).
Conclusion
Varus stem angulation should be avoided to prevent fissures. Canal fill is a poor indicator of optimal stem size and the current recommendation of >85% is unnecessarily high. Postoperative templating may be useful for assessing appropriateness of stem size.</description><identifier>ISSN: 0161-3499</identifier><identifier>EISSN: 1532-950X</identifier><identifier>DOI: 10.1111/vsu.12666</identifier><identifier>PMID: 28460422</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Animals ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Hip - methods ; Arthroplasty, Replacement, Hip - veterinary ; Biomedical materials ; Chromium ; Cobalt ; Complications ; Cracks ; Dogs ; Femur ; Hip ; Hip joint ; Joint surgery ; Postoperative Complications - etiology ; Postoperative Complications - veterinary ; Postoperative Period ; Radiographs ; Radiography ; Retrospective Studies ; Reviews ; Sizing ; Skull ; Studies ; Subsidence ; Surgery ; Surgical implants ; Total hip arthroplasty</subject><ispartof>Veterinary surgery, 2017-08, Vol.46 (6), p.803-811</ispartof><rights>2017 The American College of Veterinary Surgeons</rights><rights>2017 The American College of Veterinary Surgeons.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-7255cb34f35415e5bf40ea0a158bc1bd43aec668758fa8f1adb73f8f5e14387f3</citedby><cites>FETCH-LOGICAL-c3886-7255cb34f35415e5bf40ea0a158bc1bd43aec668758fa8f1adb73f8f5e14387f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fvsu.12666$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fvsu.12666$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28460422$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Townsend, Sarah</creatorcontrib><creatorcontrib>Kim, Stanley E.</creatorcontrib><creatorcontrib>Pozzi, Antonio</creatorcontrib><title>Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty</title><title>Veterinary surgery</title><addtitle>Vet Surg</addtitle><description>Objective
To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA).
Study design
Retrospective case series.
Animals
Fifty‐five dogs; 58 THAs.
Methods
Eighty cobalt‐chromium BFX THAs were reviewed, 58 met inclusion criteria. Implant size, positioning, and major complications within 12 months of surgery were recorded. Femoral canal flare (FCF), canal fill, stem angle, and subsidence at 3 months were measured from postoperative radiographs. Appropriateness of final stem size was assessed with digital templates. Odds ratios for associations were calculated.
Results
Mean ± SD coronal canal fill (Fillcor) was 75% ± 6, FCF was 2.0 ± 0.3, and subsidence was 1.7 mm ± 2.6. Stem angulation ranged from 7° varus to 6° valgus, and 7° cranial to 3° caudal. Appropriately sized stems (n = 45) had a mean Fillcor of 78%. Major stem complications occurred in 12% of THAs. Femora with subsidence > 3 mm were 45.3 times more likely to develop postoperative stem complications (P = .02). Stems with varus angulation ≥ 5° were 12.5 times more likely to sustain intraoperative fissures (P = .03). Stems considered undersized based on postoperative digital templating were 5.6 times more likely to develop stem complications (P = .04) and 5.7 times more likely to subside > 3 mm (P = .03).
Conclusion
Varus stem angulation should be avoided to prevent fissures. Canal fill is a poor indicator of optimal stem size and the current recommendation of >85% is unnecessarily high. Postoperative templating may be useful for assessing appropriateness of stem size.</description><subject>Animals</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Hip - methods</subject><subject>Arthroplasty, Replacement, Hip - veterinary</subject><subject>Biomedical materials</subject><subject>Chromium</subject><subject>Cobalt</subject><subject>Complications</subject><subject>Cracks</subject><subject>Dogs</subject><subject>Femur</subject><subject>Hip</subject><subject>Hip joint</subject><subject>Joint surgery</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - veterinary</subject><subject>Postoperative Period</subject><subject>Radiographs</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Reviews</subject><subject>Sizing</subject><subject>Skull</subject><subject>Studies</subject><subject>Subsidence</subject><subject>Surgery</subject><subject>Surgical implants</subject><subject>Total hip arthroplasty</subject><issn>0161-3499</issn><issn>1532-950X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9u1DAQhy0EokvhwAsgS1zKIa0d_4lzRKtSkCpxgCJuluMds66SOHiclu2JR-AZeRKybOGAxGikkeVPn0bzI-Q5Z6d8qbMbnE95rbV-QFZcibpqFfv8kKwY17wSsm2PyBPEa8ZYK6V4TI5qIzWTdb0i385DAF9oChQLDBTjXRy_UDdu6JQwlphGujRuUy4_v_8okAfq0zD10bv9J9LbWLbUuzGOQKcMiDTEQj0MMJZ-_yypuJ5u40RdLtucpt5h2T0lj4LrEZ7dz2Ny9eb84_ptdfn-4t369WXlhTG6amqlfCdkEEpyBaoLkoFjjivTed5tpHDgtTaNMsGZwN2ma0QwQQGXwjRBHJOTg3fK6esMWOwQ0UPfuxHSjJabVireNtIs6Mt_0Os053HZzvK2lkYp3aiFenWgfE6IGYKdchxc3lnO7D4Ou8Rhf8exsC_ujXM3wOYv-ef-C3B2AG5jD7v_m-ynD1cH5S8ik5d_</recordid><startdate>201708</startdate><enddate>201708</enddate><creator>Townsend, Sarah</creator><creator>Kim, Stanley E.</creator><creator>Pozzi, Antonio</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201708</creationdate><title>Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty</title><author>Townsend, Sarah ; Kim, Stanley E. ; Pozzi, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-7255cb34f35415e5bf40ea0a158bc1bd43aec668758fa8f1adb73f8f5e14387f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Animals</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Hip - methods</topic><topic>Arthroplasty, Replacement, Hip - veterinary</topic><topic>Biomedical materials</topic><topic>Chromium</topic><topic>Cobalt</topic><topic>Complications</topic><topic>Cracks</topic><topic>Dogs</topic><topic>Femur</topic><topic>Hip</topic><topic>Hip joint</topic><topic>Joint surgery</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - veterinary</topic><topic>Postoperative Period</topic><topic>Radiographs</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Reviews</topic><topic>Sizing</topic><topic>Skull</topic><topic>Studies</topic><topic>Subsidence</topic><topic>Surgery</topic><topic>Surgical implants</topic><topic>Total hip arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Townsend, Sarah</creatorcontrib><creatorcontrib>Kim, Stanley E.</creatorcontrib><creatorcontrib>Pozzi, Antonio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Veterinary surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Townsend, Sarah</au><au>Kim, Stanley E.</au><au>Pozzi, Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty</atitle><jtitle>Veterinary surgery</jtitle><addtitle>Vet Surg</addtitle><date>2017-08</date><risdate>2017</risdate><volume>46</volume><issue>6</issue><spage>803</spage><epage>811</epage><pages>803-811</pages><issn>0161-3499</issn><eissn>1532-950X</eissn><abstract>Objective
To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA).
Study design
Retrospective case series.
Animals
Fifty‐five dogs; 58 THAs.
Methods
Eighty cobalt‐chromium BFX THAs were reviewed, 58 met inclusion criteria. Implant size, positioning, and major complications within 12 months of surgery were recorded. Femoral canal flare (FCF), canal fill, stem angle, and subsidence at 3 months were measured from postoperative radiographs. Appropriateness of final stem size was assessed with digital templates. Odds ratios for associations were calculated.
Results
Mean ± SD coronal canal fill (Fillcor) was 75% ± 6, FCF was 2.0 ± 0.3, and subsidence was 1.7 mm ± 2.6. Stem angulation ranged from 7° varus to 6° valgus, and 7° cranial to 3° caudal. Appropriately sized stems (n = 45) had a mean Fillcor of 78%. Major stem complications occurred in 12% of THAs. Femora with subsidence > 3 mm were 45.3 times more likely to develop postoperative stem complications (P = .02). Stems with varus angulation ≥ 5° were 12.5 times more likely to sustain intraoperative fissures (P = .03). Stems considered undersized based on postoperative digital templating were 5.6 times more likely to develop stem complications (P = .04) and 5.7 times more likely to subside > 3 mm (P = .03).
Conclusion
Varus stem angulation should be avoided to prevent fissures. Canal fill is a poor indicator of optimal stem size and the current recommendation of >85% is unnecessarily high. Postoperative templating may be useful for assessing appropriateness of stem size.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>28460422</pmid><doi>10.1111/vsu.12666</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Veterinary surgery, 2017-08, Vol.46 (6), p.803-811 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Animals Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - methods Arthroplasty, Replacement, Hip - veterinary Biomedical materials Chromium Cobalt Complications Cracks Dogs Femur Hip Hip joint Joint surgery Postoperative Complications - etiology Postoperative Complications - veterinary Postoperative Period Radiographs Radiography Retrospective Studies Reviews Sizing Skull Studies Subsidence Surgery Surgical implants Total hip arthroplasty |
| title | Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty |
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