• Jung-Taek Kim, Hyung Jun Jeong, Soong Joon Lee, Hee Joong Kim, and Jeong Joon Yoo.
• Department of Orthopedic Surgery, Ajou University School of Medicine, Ajou Medical Center, Yeongtong-gu, Suwon-si, Gyeonggi-do, Korea.
• Indian J Orthop. 2019 Jan 1; 53 (1): 94-101.

BackgroundTotal hip arthroplasty (THA) with a proximally coated single-wedge (PSW) cementless stem had been generally considered not to be suitable for Dorr Type C femurs. This study compares the long term outcomes of PSW stem according to the type of proximal femoral geometry.Materials And Methods307 primary THAs in 247 patients were performed with PSW cementless stem and followed up for over 10 years in this retrospective study. According to Dorr's criteria, 89 femurs were classified as Type A, 156 as Type B, and 62 as Type C. They were followed up for an average of 13.2 years (range 10.0-17.3 years). All the hips were evaluated clinically and radiologically.ResultsThere was no significant difference in stem survivorship and clinical outcomes including the incidence of thigh pain and the mean postoperative Harris hip score (HHS) in all three groups. No significant differences were observed in osteolysis, pedestal formation, or cortical hypertrophy among the groups. Radiolucent lines <2 mm in thickness in Gruen zone 4 and 7 (P = 0.003 and P = 0.044, respectively), spot-weld (P < 0.001), and stress shielding (P = 0.010) of proximal femur were more pronounced in Dorr C type femora than in Type A or B. Fifty-six intraoperative fractures were identified among 307 hips with PSW stems. The incidence of intraoperative or postoperative femoral fractures was not significantly different among the groups.ConclusionsFrom over a 10-year followup, the PSW stem provided a recommendable option with satisfactory outcomes and excellent stem survivorship regardless of the Dorr type.

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