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Preservation of the femoral neck in hip arthroplasty: results of a 13- to 17-year follow-up
Journal of Orthopaedics and Traumatology volume 1, pages 31–39 (2000)
Abstract
In prosthetic surgery of the hip, it is important to remove only the pathological tissues, preserving as much as possible the osteo-articular architecture, in particular the femoral neck and the subchondral cencellous acetabulum. This allows the bone to easily adapt to the new biomechanical situation created by the prosthesis. Our long-term study of patients who underwent total hip replacement has confirmed such presuppositions. For this study, we used a biodynamic prosthesis, composed of a Lord hemispheric screwed cup with a biequatorial liner and an anatomical stem in Cr-Co-Md with a completely madreporic surface. This prosthesis is ideally configured to preserve the femoral neck. We followed 44 prostheses for 13–17 years. The clinical results were excellent or good in 82% of cases. Thigh pain, reported in only 14% of cases, spontaneously resolved. The mobility of the prosthetic hip and the consequent functional recovery were excellent, since conserving the neck re-stabilized the natural off-set, providing good equilibrium of the hip and the periarticular muscles. Radiographic analysis revealed survival of the femoral neck in approximately 80% of cases. The madreporic surface, when associated with correct positioning of an undersized stem, allowed for osteointegration with significant bone remodeling in the long term. Distal cortical hypertropy, found in 48% of cases, made it necessary to limit the madreporic surface finish to the stem's proximal two-thirds, leaving the distal one-third smooth.
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Received: 18 January 2000/Accepted: 18 February 2000
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Pipino, F., Molfetta, L. & Grandizio, M. Preservation of the femoral neck in hip arthroplasty: results of a 13- to 17-year follow-up. J Orthopaed Traumatol 1, 31–39 (2000). https://doi.org/10.1007/s101950070026
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DOI: https://doi.org/10.1007/s101950070026