DIAGNOSIS AND CO-MORBIDITIES IMPACT ON THE SURVIVORSHIP OF UNCEMENTED FEMORAL STEMS

Dr Ashish Meena, Dr. Akshay Sharma, Dr. Anu Kumar Changkum* and Dr. Vipin Sharma

ABSTRACT

Background: The success of hip arthroplasty significantly depends on a variety of factors, including the patient's specific diagnosis leading to the need for hip replacement and the presence of comorbid health conditions. This study focuses on how different diagnoses and comorbidities influence the survivorship and functional outcomes of proximally vs. fully coated uncemented femoral stems in hip arthroplasty. Methods: Conducted as a retrospective analysis, this study compared the outcomes of proximally coated and fully coated uncemented femoral stems in patients undergoing total hip replacement. The analysis encompassed data on patient demographics, clinical diagnoses, comorbid conditions, and postoperative outcomes, including radiographic assessments and functional scores (Modified Harris Hip Score, Oxford Hip Score, and Forgotten Joint Score). Results: The study did not find significant differences in osseointegration between the two groups, as evidenced by the presence of porous interfaces and spot welds. However, differences were noted in the formation of smooth interfaces and pedestals, with a higher incidence observed in the fully coated group, suggesting potential concerns for long-term stability. Functional outcome measures indicated marginally better performance in the proximally coated group, although differences were not statistically significant across all metrics. Conclusion: The choice between proximally and fully coated uncemented femoral stems in hip arthroplasty should be informed by a comprehensive evaluation of patient-specific factors, including diagnosis and comorbidities. While both types of stems are capable of achieving satisfactory osseointegration and functional outcomes, subtle differences in their performance highlight the need for personalized implant selection to optimize patient outcomes. Further research is warranted to explore the long-term implications of these findings and to refine patient selection criteria for hip arthroplasty.

Keywords: Hip arthroplasty, uncemented femoral stems, proximally coated, fully coated, diagnosis, comorbidities, survivorship, functional outcomes.