{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T05:28:49Z","timestamp":1738042129812,"version":"3.33.0"},"reference-count":19,"publisher":"Universa BV","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>The current study aimed to objectively evaluate the fit of a rectangular, tapered stem to the severely dysplastic hips on the basis of the proximal femoral anatomy and the dimensional properties of the stem. It was hypothesized that the stem size planned with accordance to the diaphyseal canal width alone can accommodate the distal femur successfully with no sizing mismatch.\n\nForty-six patients (53 hips) suffering from secondary osteoarthritis due to hip dysplasia scheduled for total hip arthroplasty (THA) with a subtrochanteric transverse shortening osteotomy were included. All hips were Crowe type 4. All patients underwent preoperative computed tomography imaging. Height of femoral head center (HCH) was determined. Medullary canal diameter measurements at different levels were made. These were made at a level (1) 35% of HCH above the lesser trochanter (DT +35), (2) 70% of HCH below the lesser trochanter (DT -70), and (3) at the level of isthmus (Di). Medullary canal flare indices were calculated from the individual parameter ratios. Similar measurements were carried out for the different sizes of the femoral stem.\n\nThe mean DT +35 was 41.9 \u00b1 6.4 mm, the mean DT-70 was 17.3 \u00b1 2.2 mm, and the mean Di was 12.8 \u00b1 1.9 mm. In all femurs, the width of the isthmus was wider than that of the corresponding femoral stem isthmus. The femoral stem sizes established with respect to the diaphyseal width of the femur were all compatible with the isthmus width of the femur.\n\nTapered and rectangular stems can accommodate the proximal femur above and below the osteotomy level in Crowe type IV hip dyplasia patients, thereby constituting a viable option as the femoral stem in this patient group with technically demanding difficulties.<\/jats:p>","DOI":"10.52628\/90.4.13095","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T10:59:58Z","timestamp":1737975598000},"page":"581-587","source":"Crossref","is-referenced-by-count":0,"title":["Rectangular femoral stems can successfully accommodate the medullary canal in patients with severe hip dysplasia operated on with total hip arthroplasty and a shortening osteotomy: A morphometric study"],"prefix":"10.52628","volume":"90","author":[{"given":"C.D.","family":"DAVULCU","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.K.","family":"OZSAHIN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.E.","family":"KAYAALP","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"CELAYIR","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"AKBABA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.C.","family":"UNLU","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27062","published-online":{"date-parts":[[2025,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Jacobsen S, Sonne-holm S, S\u00f8balle K, Gebuhr P, Lund B. Hip dysplasia and osteoarthrosis. Acta Orthop. 2005 Jan 8;76(2):149\u201358.","DOI":"10.1080\/00016470510030517"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Enges\u00e6ter I\u00d8, Lie SA, Lehmann TG, Furnes O, Vollset SE, Enges\u00e6ter LB. Neonatal hip instability and risk of total hip replacement in young adulthood. Acta Orthop. 2008 Jan 8;79(3):321\u20136.","DOI":"10.1080\/17453670710015201"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Bicanic G, Delimar D, Delimar M, Pecina M. Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop. 2009 Apr 18;33(2):397\u2013402.","DOI":"10.1007\/s00264-008-0683-z"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ. Total Hip Arthroplasty with Shortening Subtrochanteric Osteotomy in Crowe Type-IV Developmental Dysplasia. Journal of Bone and Joint Surgery. 2010 Sep;92(Supplement_1_ Part_2):176\u201387.","DOI":"10.2106\/jbjs.j.00061"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Ahmed E, Ibrahim EG, Ayman B. Total hip arthroplasty with subtrochanteric osteotomy in neglected dysplastic hip. Int Orthop. 2015 Jan 11;39(1):27\u201333.","DOI":"10.1007\/s00264-014-2554-0"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Chareancholvanich K, Becker DA, Gustilo RB. Treatment of Congenital Dislocated Hip by Arthroplasty With FemoralShortening. Clin Orthop Relat Res. 1999 Mar;360:127\u201335.","DOI":"10.1097\/00003086-199903000-00016"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Mu W, Yang D, Xu B, Mamtimin A, Guo W, Cao L. Midterm Outcome of Cementless Total Hip Arthroplasty in Crowe IV\u2013 Hartofilakidis Type III Developmental Dysplasia of the Hip. J Arthroplasty. 2016 Mar;31(3):668\u201375.","DOI":"10.1016\/j.arth.2015.10.011"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"J F Crowe VJMCSR. Total hip replacement in congenital dislocation and dysplasia of the hip. Journal of Bone and Joint Surgery. 1979;61(1):15\u201323.","DOI":"10.2106\/00004623-197961010-00004"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Jamali AA, Deuel C, Perreira A, Salgado CJ, Hunter JC, Strong EB. Linear and angular measurements of computer- generated models: Are they accurate, valid, and reliable? Computer Aided Surgery. 2007 Jan 6;12(5):278\u201385.","DOI":"10.1080\/10929080701680265"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Sugano N, Noble PC, Kamaric E, Salama JK, Ochi T, Tullos HS. The morphology of the femur in developmental dysplasia of the hip. J Bone Joint Surg. 1998 Jul 1;80(4):711\u20139.","DOI":"10.1302\/0301-620x.80b4.8319"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Liu S, Zuo J, Li Z, Yang Y, Liu T, Xiao J, et al. Study of three-dimensional morphology of the proximal femur in developmental adult dysplasia of the hip suggests that the on-shelf modular prosthesis may not be an ideal choice for patients with Crowe type IV hips. Int Orthop. 2017 Apr 14;41(4):707\u201313.","DOI":"10.1007\/s00264-016-3248-6"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Swanson T V. The Tapered Press Fit Total Hip Arthroplasty. J Arthroplasty. 2005 Jun;20:63\u20137.","DOI":"10.1016\/j.arth.2005.03.017"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Mu W, Yang D, Xu B, Mamtimin A, Guo W, Cao L. Midterm Outcome of Cementless Total Hip Arthroplasty in Crowe IV\u2013 Hartofilakidis Type III Developmental Dysplasia of the Hip. J Arthroplasty. 2016 Mar;31(3):668\u201375.","DOI":"10.1016\/j.arth.2015.10.011"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Kayaalp ME, Can A, Erdogan F, Ozsahin MK, Aydingoz O, Kaynak G. Clinical and Radiological Results of Crowe Type 3 or 4 Dysplasia Patients Operated on With Total Hip Arthroplasty Using a Cementless Rectangular Femoral Component Without Fixating or Grafting the Transverse Osteotomy Site. J Arthroplasty. 2020 Sep;35(9):2537\u201342.","DOI":"10.1016\/j.arth.2020.04.045"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Kayaalp ME, Erdogan F, Kaynak G. The round femoral stem provides a similar clinical outcome but more serious proximal stress shielding compared to the rectangular stem in cementless total hip arthroplasty without a shortening osteotomy in patients with Crowe type 2 or 3 hip dysplasia. Jt Dis Relat Surg. 2022 Aug 1;33(2):393\u20138.","DOI":"10.52312\/jdrs.2022.525"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Bernasek TL, Haidukewych GJ, Gustke KA, Hill O, Levering M. Total Hip Arthroplasty Requiring Subtrochanteric Osteotomy for Developmental Hip Dysplasia. J Arthroplasty. 2007 Sep;22(6):145\u201350.","DOI":"10.1016\/j.arth.2007.05.014"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Masonis JL, Patel J V., Miu A, Bourne RB, McCalden R, MacDonald SJ, et al. Subtrochanteric shortening and derotational osteotomy in primary total hip arthroplasty for patients with severe hip dysplasia: 5-year follow-up. J Arthroplasty. 2003 Apr;18(3):68\u201373.","DOI":"10.1054\/arth.2003.50104"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Zweymuller K, Semlitsch M. Concept and material properties of a cementless hip prosthesis system with Al2O3 ceramic ball heads and wrought Ti-6Al-4V Stems. Archives of Orthopaedic and Traumatic Surgery. 1982 Dec;100(4):229\u201336.","DOI":"10.1007\/bf00381662"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Philip C Noble 1 EKNSMMYHKOVP. Three-dimensional shape of the dysplastic femur: implications for THR. Clin Orthop Relat Res. 2003;417:27\u201340.","DOI":"10.1097\/01.blo.0000096819.67494.32"}],"container-title":["Acta Orthopaedica Belgica"],"original-title":[],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T11:00:50Z","timestamp":1737975650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actaorthopaedica.be\/archive\/volume-90\/issue-4\/original-studies\/rectangular-femoral-stems-can-successfully-accommodate-the-medullary-canal-in-patients-with-severe-h\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,1]]},"published-print":{"date-parts":[[2024,12]]}},"URL":"https:\/\/doi.org\/10.52628\/90.4.13095","relation":{},"ISSN":["0001-6462"],"issn-type":[{"value":"0001-6462","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}