Subsidence of the BFX standard stem after canine total hip replacement: A case series of 177 consecutive procedures
🔍 Key Findings
- Median BFX stem subsidence was only 0.4 mm, but values ranged from −4.1 to 9.8 mm across 177 THRs.
- Subsidence was significantly associated with stem complications (p = .005), but not with non-stem complications (p = .76) or prosthetic luxation (p = .07).
- Most stem complications were intraoperative femoral fissures (8/11), and only one fissure progressed to postoperative femoral fracture.
- Traditional subsidence thresholds of 3 mm and 5 mm poorly predicted complications; most stems exceeding these values remained complication-free.
- Large subsidence can be clinically inconsequential, with two stems demonstrating 8.8 mm and 9.8 mm of subsidence without complications.
- Canal flare index, canal fill, and stem orientation were not associated with subsidence, suggesting limited predictive value of these radiographic measurements.
- Subsidence may reflect consequences of intraoperative fissures rather than cause complications, supporting a possible reverse-causality relationship.
- Clinical interpretation of subsidence should be contextual, considering fissures, implant sizing, femoral morphology, and patient factors rather than relying on numeric cutoffs alone.
Simini Surgery Review Podcast
🔍 Key Findings
- Median BFX stem subsidence was only 0.4 mm, but values ranged from −4.1 to 9.8 mm across 177 THRs.
- Subsidence was significantly associated with stem complications (p = .005), but not with non-stem complications (p = .76) or prosthetic luxation (p = .07).
- Most stem complications were intraoperative femoral fissures (8/11), and only one fissure progressed to postoperative femoral fracture.
- Traditional subsidence thresholds of 3 mm and 5 mm poorly predicted complications; most stems exceeding these values remained complication-free.
- Large subsidence can be clinically inconsequential, with two stems demonstrating 8.8 mm and 9.8 mm of subsidence without complications.
- Canal flare index, canal fill, and stem orientation were not associated with subsidence, suggesting limited predictive value of these radiographic measurements.
- Subsidence may reflect consequences of intraoperative fissures rather than cause complications, supporting a possible reverse-causality relationship.
- Clinical interpretation of subsidence should be contextual, considering fissures, implant sizing, femoral morphology, and patient factors rather than relying on numeric cutoffs alone.
Simini Surgery Review Podcast
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