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Related Experiment Videos

Varus migration of PCA stems

M D Ries1, F Lynch, P Jenkins

  • 1Mary Imogene Bassett Hospital, Cooperstown, NY 13326, USA.

Orthopedics
|July 1, 1996
PubMed
Summary

Varus migration of cementless hip stems occurred in 15% of patients, potentially linked to poor distal stability. This migration was associated with thigh pain and specific radiographic findings.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Radiology

Background:

  • Cementless, porous-coated anatomic hip replacements are widely used.
  • Understanding factors influencing implant migration is crucial for long-term success.
  • Varus migration of the femoral stem can lead to adverse outcomes.

Purpose of the Study:

  • To evaluate varus migration of cementless porous-coated anatomic hip stems.
  • To identify radiographic predictors and clinical associations of stem varus migration.
  • To investigate the relationship between femur rotation, lesser trochanter size, and stem position.

Main Methods:

  • Retrospective analysis of 47 patients with cementless hip replacements (minimum 2-year follow-up).
  • Radiographic assessment for varus migration and associated features (percent canal fill, radiodense lines).
  • Cadaver study to correlate radiographic lesser trochanter projection, femur rotation, and stem position.

Main Results:

  • Seven patients (15%) demonstrated varus stem migration with lateral distal tip displacement.
  • Thigh pain was reported in patients with varus migration and those with no stem position change.
  • Varus migration correlated with lower lateral radiograph percent canal fill (P < .001) and wider radiodense lines in zones 1 and 6 (P < .005).

Conclusions:

  • Poor distal femoral canal fill on lateral radiographs may predispose to varus stem migration.
  • Varus migration is associated with specific radiographic indicators and clinical symptoms like thigh pain.
  • Further research into optimizing stem fit and fixation is warranted to prevent varus migration.

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