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Is The Size of the Currently Available Implants for Total Hip Arthroplasty Adequate for Our Population?[*]Article in several languages: português | English
21 September 2018
02 February 2019
20 August 2019 (online)
Objective To determine if the dimensions of selected national and imported implants used in total hip arthroplasty surgeries are adequate regarding the anthropometric profile of the Brazilian population.
Methods A retrospective study of patients submitted to primary total hip arthroplasty. Patients with femoral or acetabular morphological deformities that could influence the choice of implant size, including dysplasia and previous fractures, were excluded from the study. Two national implants and six imported implants were included in the study. Every patient was treated by the same group, with one of the four senior authors or under their strict supervision, following the same surgical technique. The data were analyzed regarding gender, age, fixation type and implant model.
Results The analysis of 682 hips submitted to total hip arthroplasty demonstrated that 2 models of cemented femoral stems and 1 of non-cemented stem did not seem to be perfectly adequate for the femoral morphology of the studied population, since these 3 implants were mostly used in the smallest size available, resulting in a non-Gaussian curve. The mean diameter of the native acetabulum was 54 mm in men and 52 mm in women.
Conclusion Out of the eight models studied, five were deemed adequate for the studied population. The other three models available in our market (two national models and one imported model) apparently require more appropriate sizing. We emphasize that anthropometric studies of the Brazilian hip are necessary to give scientific subsidies to the ideal implant design for our market.
* Work developed at the Hip Surgery Service, Hospital Angelina Caron, Campina Grande do Sul, Paraná, PR, Brazil.
- 1 Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet 2007; 370 (9597): 1508-1519
- 2 Bourne RB, Rorabeck CH. Soft tissue balancing: the hip. J Arthroplasty 2002; 17 (04) (Suppl. 01) 17-22
- 3 Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, Rorabeck CH. Soft-tissue balancing of the hip: the role of femoral offset restoration. Instr Course Lect 2005; 54: 131-141
- 4 Nieves JW, Formica C, Ruffing J. , et al. Males have larger skeletal size and bone mass than females, despite comparable body size. J Bone Miner Res 2005; 20 (03) 529-535
- 5 Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS. The anatomic basis of femoral component design. Clin Orthop Relat Res 1988; (235) 148-165
- 6 Wang SC, Brede C, Lange D. , et al. Gender differences in hip anatomy: possible implications for injury tolerance in frontal collisions. Annu Proc Assoc Adv Automot Med 2004; 48: 287-301
- 7 Kaptoge S, Dalzell N, Loveridge N, Beck TJ, Khaw KT, Reeve J. Effects of gender, anthropometric variables, and aging on the evolution of hip strength in men and women aged over 65. Bone 2003; 32 (05) 561-570
- 8 Sariali E, Mouttet A, Pasquier G, Durante E. Three-dimensional hip anatomy in osteoarthritis. Analysis of the femoral offset. J Arthroplasty 2009; 24 (06) 990-997
- 9 Traina F, De Clerico M, Biondi F, Pilla F, Tassinari E, Toni A. Sex differences in hip morphology: is stem modularity effective for total hip replacement?. J Bone Joint Surg Am 2009; 91 (Suppl. 06) 121-128
- 10 IBGE - Instituto Brasileiro de Geografia e Estatística. Indicadores Sociodemográficos e de Saúde no Brasil-2009. Disponível em: http://biblioteca.ibge.gov.br/visualizacao/livros/ liv42597.pdf