N°004 - January / February 2020
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Radiological modes of fixation of a tapered, wedged proximally coated femoral stem
By Amar RANAWAT in category UPDATE
Hospital for Special Surgery – New York
Modes of fixation of cementless femoral stems have important clinical implications as they determine the initial fixation and subsequent bone ingrowth [1,2]. Tapered wedge femoral stems with proximal porous coating were introduced to reduce stress shielding of the proximal femur and reduce the incidence of thigh pain, and have shown excellent intermediate and long-term results [1, 3-15]. However, implant shapes and sizes do not always perfectly match the patient’s femoral geometry and there is always a risk of intra-operative femur fracture with oversized components and the risk of subsidence and early mechanical failure with undersized components. Although these stems are designed to feature proximal, canal filling bone contact, it may not always be possible to get a proximal wedging of the stem due to variation in femoral geometry as well as the operative technique . Thus an additional mode of 3 point fixation pattern has also been described for these implants . However, we have observed other modes of radiological fixation without clinical or radiological failure. The aim of this study was to analyze the results of a tapered, proximally hydroxyapatite coated uncemented femoral stem (Accolade TMZF®, Stryker Orthopedics, Mahwah, NJ) and to describe...
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