Cementless rectangular stems yield satisfactory results in osteoporotic bones

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Geriatric Medicine

Background:

• Osteoporosis significantly impacts bone quality, potentially affecting prosthesis survival in hip arthroplasty.
• Comparing femoral stem survival in patients with varying bone densities is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To investigate the influence of osteoporosis on cementless femoral stem survival.
• To compare prosthesis survival rates between patients with moderate (Dorr Type B) and advanced (Dorr Type C) osteoporosis.

Main Methods:

• Retrospective analysis of 61 patients with femoral neck fractures treated with cementless rectangular stems.
• Preoperative radiographs assessed using the Dorr classification to categorize bone quality (Type B vs. Type C).
• Femoral component survival evaluated using Engh and ARA criteria, with statistical comparison via Mann-Whitney U test.

Main Results:

• No statistically significant difference in ARA scores between Dorr Type B (median 5) and Type C (median 5) groups (p=0.24).
• No statistically significant difference in Engh values between Dorr Type B (median 16.5) and Type C (median 14) groups (p=0.061).
• Loosening scores (ARA and Engh) showed no significant difference between moderate and advanced osteoporotic groups.

Conclusions:

• Cementless hip arthroplasty is a viable option for elderly patients, including those with advanced osteoporosis.
• The procedure does not appear to carry additional intraoperative or postoperative risks in osteoporotic patients.
• Bone quality, as classified by Dorr, did not significantly impact cementless femoral stem survival in this cohort.