ARTHROPLASTY
THA: Cylindrical stem distal design relieves distal loading
J Arthroplasty. 2012 Sep;27(8):1538-43. Epub 2012 Mar 14.21 patients requiring bilateral total hip arthroplasty received two different hip prostheses, one with a distally tapered stem and the other with a distally cylindrical stem to determine the effect of the distal design on bone remodelling. Patients were randomized as to which leg received the different prostheses. 7 years after surgery, all patients displayed good clinical and radiographic outcomes. Cancellous condensation was found in Gruen's zones 2 and 6 around the cylindrical stem and between Gruen's zones 2 and 3, and zones 5 and 6 around the tapered stem. Bone mineral density around Gruen's zones 2 and 6 was significantly lower around the tapered stem than the cylindrical stem, indicating the tapered stems may experience more distal loading than the cylindrical stems.
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