The calcar femorale in cemented stem fixation in total hip arthroplasty.
J Bone Joint Surg Br
; 82(6): 842-5, 2000 Aug.
Article
em En
| MEDLINE
| ID: mdl-10990308
ABSTRACT
The calcar femorale is a vertical plate of bone lying deep to the lesser trochanter and is formed as a result of traction of the iliopsoas which separates the femoral cortex into two distinct layers, the calcar femorale and the medial femoral cortex. They fuse together proximally to form the medial femoral neck. A stem placed centrally will abut against the calcar femorale with little or no space for cement. Clearing of the calcar will offer space for a cement layer, which will support the stem proximally on the posterior aspect. We compared two consecutive groups of Charnley low-friction arthroplasties, with and without clearing of the calcar. In 330 patients who had an arthroplasty without clearing the calcar, there were ten revisions for aseptic loosening of the stem and six other stems were considered 'definitely loose', giving a rate of failure of 4.8%. In 111 patients in whom the calcar was cleared there was only one revision for aseptic loosening and no stems were classed as 'definitely loose', giving a rate of failure of 0.9%. Survivorship analysis has again shown the need for long-term follow-up; the differences became clear after ten years but because of the relatively small numbers, statistical analysis is not yet applicable. We now clear the calcar femorale routinely and advocate optimal access to the medullary canal and insertion of the stem in the area of the piriform fossa.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteotomia
/
Cimentos Ósseos
/
Artroplastia de Quadril
/
Colo do Fêmur
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Bone Joint Surg Br
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Reino Unido