Objective: We aimed to demonstrate the methods of treatment for coxa vara with modular total hip arthroplasty (THA) and evaluate clinical and radiographic outcomes, and further survivorship at the midterm follow-up.
Methods: We retrospectively reviewed 33 patients (42 hips) who underwent modular THA for coxa vara deformity from May 2008 to December 2019. The clinical and radiographic results, including Harris Hip Score (HHS), leg length discrepancy (LLD), greater trochanteric height, femoral offset, abductor lever arm, stem alignment and limp, and complications, were evaluated.
Results: The follow-up time was mean 69.9±43.7 months. Clinically, the HHS improved significantly (p<0.001) on average from 42.90±14.44 points to 89.54±4.75 points. The mean LLD decreased from 33.3±19.4 mm to 5.0±5.8 mm (p<0.001), and 27 patients (82%) thought that total equality of the lower limbs was obtained. Patients demonstrated diminished or no limping in 88% (29/33) of hips and a significant improvement of biomechanics. At the final follow-up, all stems of hips were in clinical neutral alignment and the prostheses survivorship rates for all-causes revisions was 97.6%.
Conclusion: Modular THA is a valuable alternative to render favorable outcomes for treatment of osteoarthritis secondary to severe coxa vara.
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| http://dx.doi.org/10.2147/TCRM.S335015 | DOI Listing |
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Article Synopsis
- The study explores the risk of periprosthetic femoral fractures (PFF) following total hip arthroplasty (THA) using a direct anterior approach (DAA) with a specialized femoral stem design.
- A review of data from 2019 to 2021 showed a low incidence of PFF (1.6%), with the majority occurring intraoperatively and some being detected postoperatively.
- Key risk factors for fractures identified include female gender and specific preoperative femoral neck angles (coxavalga and coxavara), supporting previous findings in the literature.
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