Análisis clínico-radiológico comparativo de tallos femorales no cementados planos de primera vs. segunda generación

Introduction: The design of the femoral implant is essential for its adaptation to the different types of femoral canals. The objective of this study is to describe the adaptability of the implant and the type of fixation (fill and fit) of second-generation flat femoral stems compared to first-generation femoral stems. Materials and Methods: We described the radiological characteristics of patients who had undergone bilateral total hip replacement between 2007 and 2020 in our institution with both a first-generation AccoladeTMZF (Stryker Orthopedics) and a second-generation Accolade II (Stryker Orthopedics) flat cementless femoral implant. Demographic variables, adaptation, and canal filling were studied. The modified Harris Hip Score and the WOMAC index were analyzed. Results: Forty-two patients (84 cases) were included in the sample. In group 1 (Accolade TMZF) we obtained an average canal fill of 81% and in group 2 (Accolade II), we obtained an average of 84%. In group 1, the type of fixation (fit) was type 1 (60%), type 2 (16%) and type 3 (24%). In group 2, it was type 1 (88%), type 2 (7%) and type 3 (5%). The modified Harris Hip Score for group 1 was 88 and, for group 2, 87.5. The WOMAC score for group 1 was 2.5 and for group 2 it was 3. Conclusion: The adaptability of the implant is essential for primary stability and its osseointegration/biological fixation. This adaptability is more precise with second-generation flat femoral stems.