Reconstruction of the anatomy of the hip in total hip arthroplasty with two different kinds of stems

BACKGROUND: The reconstruction of the individual anatomy is important in total hip replacement. The aim of the study was to compare two different kinds of stems with respect to the reconstruction of the individual anatomy of the hip.

METHODS: We compared the restoration of the anatomical parameters (horizontal and vertical offset, femoral neck-shaft angle (NSA) and leg length) of 100 unilateral CoreHip (CH) implantations with 100 unilateral implantations of a standard anatomical stem (Exception (E)). The CoreHip has three different NSAs and exhibits a constant femoral neck length for the different sizes. The Exception stem has a standard and lateralized version with two different NSAs and, in both versions, the femoral neck length increases proportionately with size. The anatomical parameters of the operated and healthy sides were measured and the differences between the two stems compared.

RESULTS: The horizontal (2.5 ± 2.8 mm (mean ± SD) for CH vs. 5.4 ± 4.1 mm for E, p < 0.001) and vertical offset (4.1 ± 3.5 mm for CH vs. 5.0 ± 3.8 mm, p = 0.024) and femoral neck-shaft-angle (1.7 ± 1.6 degrees for CH vs. 5.6 ± 3.4 degrees for E, p < 0.001) could be reconstructed significantly better with the CoreHip system. There was a tendency for the leg length (4.0 ± 3.9 mm for CH vs. 4.5 ± 3.8 mm; p = 0.11) to be better restored with the CoreHip.

CONCLUSION: The reconstruction of the individual anatomy of the hip with an endoprosthesis could be realized significantly better with the stem that was designed with three different femoral neck-shaft angles and a constant femoral neck length over different sizes.