Is a THA Stem in Varus a Risk Factor of Long-term Mechanical Complication

Study Overview
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Brief Summary
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The objective of this study is to compare the long-term survival as well as the functional and radiographic results of the rods in the alignment of the varus to the stems in the neutral alignment by comparing 2 groups of implanted Total Hip Arthroplasty. 1 group of stems implanted in varus position. 1 group of stems implanted in neutral position

Detailed Description
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ABSTRACT: Introduction: Femoral stem positioning in the frontal plane has always been considered a fundamental criterion for implant survival and for functional and radiographic outcomes in total hip arthroplasty (THA). The impact of implanting cementless femoral stems in varus alignment on long-term mechanical complications remains poorly defined in the literature. The aim of our study is to compare long-term survivorship as well as functional and radiographic outcomes of stems in varus alignment to stems in neutral alignment. Patients and Methods: This single center, multi-surgeon, retrospective case-control study will compare a group of 105 THA patients with varus stem alignment (VS) to a control group of 105 THA patients with neutral stem alignment (NS), operated in Brest center between January 2007 and December 2012. The primary outcome measure is implant survival. Secondary outcomes include functional outcomes: HHS, PMA, thigh pain, dislocation and hip ROM; and radiographic outcomes: radiolucency, Agora Roentgenography Assessment (ARA) score, osseointegration, heterotopic ossification, subsidence and stress shielding.

Official Title
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Is a THA Stem in Varus a Risk Factor of Long-term Mechanical Complication

Conditions
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Hip Arthritis

Intervention / Treatment
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* Procedure: Total Hip Arthroplasty


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: PTH rod implanted in varus, Having X-rays and clinical data in their file Within a period of less than 6 months No opposition Exclusion Criteria: PTH in a context of fracture of the femoral neck PTH 2nd intention Lost to sight Patients who died within 6 months Refusal to participate

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Varus Stems<br>Patients with a THA Stem implanted in Varus position | Procedure: Total Hip Arthroplasty<br>* Patient were operated, a Total hip arthroplasty was performed<br>|
| Neutral stems<br>Patients with a THA Stem implanted in Neutral position | Procedure: Total Hip Arthroplasty<br>* Patient were operated, a Total hip arthroplasty was performed<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival rate | The main outcome measured was the survival of the implant | It was measured in October 2021 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HHS | Functional outcome : - The Harris Hip Score (HHS) [26] which assesses pain, function, deformity and range of motion (ROM) with a maximum score of 100 | It was measured in October 2021 | 
| PMA score : | Functional outcome : which assesses pain, gait and mobility with a maximum score of 18 | It was measured in October 2021 | 
| Thigh pain | Functional outcome : we measured the rate of patients experiencing pain at the level of the thigh | It was measured in October 2021 | 
| Dislocation | Functional outcome : hip disclocation rate over the follow up period | It was measured in October 2021 | 
| Hip ROM | Functional outcome : Hip range of motion in flexion, adduction, extension, abduction and rotations | It was measured in October 2021 | 
| Radiolucency | Radiographic outcome : - Radiolucency according to the Gruen/Callaghan zones | It was measured in October 2021 | 
| Agora Roentgenography Assessment (ARA) score | Radiographic outcome : - Agora Roentgenography Assessment (ARA) score for cementless femoral stem stability according to Epinette | It was measured in October 2021 | 
| Osseointegration | Radiographic outcome mesured was described in Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components Engh CA, Massin P, Suthers KE | It was measured in October 2021 | 
| Heterotopic ossification | Radiographic outcome : - Brooker classification of heterotopic ossification | t was measured in October 2021 | 
| Subsidence | Radiographic outcome : - Subsidence: considered significant if more than 5 mm between the immediate postoperative x-ray and the last follow-up x-ray. Subsidence was assessed by measuring the distance between the tip of the trochanter and the shoulder of the stem | t was measured in October 2021 | 
| Stress shielding. | Radiographic outcome : we measured the rate of patients with Xray showing stress shielding signs | t was measured in October 2021 |