Therapeutics and Clinical Risk Management (Nov 2021)

Treatment of Osteoarthritis Secondary to Severe Coxa Vara with Modular Total Hip Arthroplasty

  • Zhang B,
  • Sun J,
  • Du Y,
  • Shen J,
  • Li T,
  • Zhou Y

Journal volume & issue
Vol. Volume 17
pp. 1199 – 1207


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Bohan Zhang,1,2,* Jingyang Sun,1,2,* Yinqiao Du,2,3 Junmin Shen,2,4 Tiejian Li,1,2 Yonggang Zhou1– 3 1Medical School of Chinese PLA, Beijing, 100853, People’s Republic of China; 2Department of Orthopedics, The First Medical Center of PLA General Hospital, Beijing, 100853, People’s Republic of China; 3Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, 100048, People’s Republic of China; 4Medical School of Nankai University, Tianjin, 300071, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yonggang ZhouDepartment of Orthopedics, The First Medical Center, Chinese People’s Liberation Army General Hospital, 28th Fuxing Road, Haidian District, Beijing, People’s Republic of ChinaTel +8613801287599Email [email protected]: We aimed to demonstrate the methods of treatment for coxa vara with modular total hip arthroplasty (THA) and evaluate clinical and radiographic outcomes, and further survivorship at the midterm follow-up.Methods: We retrospectively reviewed 33 patients (42 hips) who underwent modular THA for coxa vara deformity from May 2008 to December 2019. The clinical and radiographic results, including Harris Hip Score (HHS), leg length discrepancy (LLD), greater trochanteric height, femoral offset, abductor lever arm, stem alignment and limp, and complications, were evaluated.Results: The follow-up time was mean 69.9± 43.7 months. Clinically, the HHS improved significantly (p< 0.001) on average from 42.90± 14.44 points to 89.54± 4.75 points. The mean LLD decreased from 33.3± 19.4 mm to 5.0± 5.8 mm (p< 0.001), and 27 patients (82%) thought that total equality of the lower limbs was obtained. Patients demonstrated diminished or no limping in 88% (29/33) of hips and a significant improvement of biomechanics. At the final follow-up, all stems of hips were in clinical neutral alignment and the prostheses survivorship rates for all-causes revisions was 97.6%.Conclusion: Modular THA is a valuable alternative to render favorable outcomes for treatment of osteoarthritis secondary to severe coxa vara.Keywords: osteoarthritis, coxa vara, modular, total hip arthroplasty