1. CONCLUSIONS
Early clinical and radiographic follow up was comparable to our previous results with a straight uncemented standard stem. With new GTS stem we could appro-
priately reconstruct the pre-op morphotype and morphometry on a wide range of population without any increase in complications rate also without any patient
selection.
DISCUSSION
Register data shows that demographic range gets wider and patient’s activity level rises continuously. Straight uncemented stems for THA show very good clini-
cal and radiographic results but leave important questions open regarding bone and muscle sparing. Short stems allow M.I.S. and bone stock preservation but
leave questions open regarding their primary stability and restore of morphometric parameters capability that had limited their indications (ranging from 5% to
30% in italian surgery centers). Our off-set dispersion chart (above) demonstrates how it’s possible with GTS stem to reproduce hip native morphology combi-
ning size and CCD options (varized 122° and standard 133°) without any increase in complication rate.
RESULTS
We found average clinical scores similar to our previous studies with other stems.
We performed a radiographic analysis of implants with a 1 year minimum follow up (100 stems, 96 patients). We measured cervico-diaphyseal angle,
flare index and cortico-medullary index on pre op x-rays and cervico-diaphyseal angle, metaphyseal filling rate and bone resorption signs on post op
x-rays. We also evaluated legs length discrepancy and off-set reconstruction. The average pre-op C/D angle and off- set were 130.7 degrees and 51.0
mm. while post-op were 128.3 degrees and 50.23 mm. with a legs lenght discrepancy that ranges from 12.0 to 2.0 mm. No clinical or radiological signs
of loosenings at 1 year follow-ups.
In the whole 570 hips we had five cases (0,9%) of intra-op femoral crack (3 required immediate treatment by wiring or screw). One traumatic fracture
in the rehabilitation period was revised with a long conical stem and 3 cases of early septic complications underwent debridement. We reported only one
luxation, early manually reduced.
Arthritis Etiology
Secondary; 18%
F.A.I. Related; 21%
Idiopathic; 61%
Secondary Causes
Post-traumatic Arthritis; 11%
Perthes; 14%
Femoral Head Necrosis; 24%
DDH; 51%
Cups Tribology
Metal On Poly; 9%
Metal On Metal; 15%
Ceramics on Ceramics; 19%
Ceramics on Poly; 57%
MATHERIALS AND METHODS
In first 12 months 539 patients (570 hips, 31 bilateral) undergone a THA based on GTS: 282 males, 257 females, average age 57,8 years. Etiology: idio-
pathic 61%, F.A.I. related 21%, secondary 18% (41 DDH, 19 femoral head necrosis, 11 Perthes sequelae, 9 posttraumatic arthritis). Tribology: 306 cera-
mics on poly, 103 ceramics on ceramics, 81 metal on metal, 49 metal on poly. Standard 133° stem in 485 cases and varus 122° stem in 85 cases. We
prospectically evaluated our patients with clinical and x-ray controls at 1, 3, 6 and 12 months.
INTRODUCTION
In January 2010 we began our experience with a new uncemented short stem. GTS is a throcanter sparing stem with a grit blasted titanium alloy and a
tapered wedge geometry with full-surface fins.
EARLY RESULTS OF THE NEW GTS UNCEMENTED STEM:
OUTCOME OF FIRST 570 CONSECUTIVE CASES