Varus Stem Positioning of a Cementless Anatomical THA. (VARABG)

Study Overview
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Brief Summary
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Varus positioning is the most common femoral malposition in total hip arthroplasty (THA). The aim of this study was to compare the long-term results of an anatomical cementless femoral stem positioned in varus with those in neutral alignment.

Detailed Description
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Data were prospectively collected and retrospectively reviewed for all patients who received a cementless anatomical femoral stem in THA between 1998 and 2008. After exclusion criteria applied, 127 stems had an varus axis deviated by more than 3 degrees (varus group) and 156 had an alignment between 0 and 2.9° from the femoral axis (neutral group). Survivorship rates, complications, clinical scores, thigh pain, radiological score, cortical hypertrophy and filling rate were analyzed. Mean follow-up was 10 years.

Official Title
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Varus Stem Positioning Does Not Affect Long-term Functional Outcome in Cementless Anatomical Total Hip Arthroplasty.

Conditions
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Osteoarthritis, Arthroplasty Complications

Intervention / Treatment
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* Diagnostic Test: Xray


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients received by several senior surgeons, the same standardized posterolateral total hip arthroplasty, and the same rehabilitation protocol. Exclusion Criteria: Etiologies other than osteoarthritis (osteonecrosis, fracture, dysplasia, rheumatoïd arthritis), Complex cases with additional procedure, Dual-taper modular or cemented stem, Incomplete preoperative data or less than one-year postoperative data.

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 group<br>Radiographic stem axis was assessed on standard anteroposterior hip radiographs performed at the 3-month follow-up visit. Alignment was evaluated as described by Reina et al., by the angular deviation of the anatomic femoral axis and the stem axis. The 3 degrees minimal-value was considered to be the threshold defining a varus stem. | Diagnostic Test: Xray<br>* Hip AP Xray<br>|
| Neutral group<br>Alignment between anatomic femoral axis ans stem axis was less than 3°. | Diagnostic Test: Xray<br>* Hip AP Xray<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Long-term survival of THA with varus or neutral cementless fixation of a proximal HA-coated anatomic tapered femoral stem. | Kaplan-Meier survivorships free of revision of the femoral component for any reason, femoral fracture and revision of femoral component for fracture were calculated and compared by log-rank test for both group. | Survival evaluation was carried out through study completion at an average of 10 years by the surgeon. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Long-term clinical outcomes with varus or neutral femoral stem. | Clinical status was assessed by the Harris hip score (HHS). | Clinical evaluation was carried out through study completion at an average of 10 years by the surgeon. | 
| Long-term radiological outcomes with varus or neutral femoral stem. | Radiological assessment was conducted at the last follow-up in charge antero-posterior and profile X-Ray. | Radiological evaluation was carried out through study completion at an average of 10 years by the surgeon. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total hip arthroplasty, varus alignment, anatomical stem, survivorship