Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology?

Luger, Matthias; Feldler, Sandra; Gahleitner, Manuel; Pisecky, Lorenz; Gotterbarm, Tobias; Stadler, Christian

doi:10.1186/s13018-025-05502-y

Journal of Orthopaedic Surgery and Research

Table 5 Distribution of Dorr classification, pelvic and femoral morphological parameters between both stem types by Vancouver Type A and B

From: Periprosthetic femoral fractures in minimally-invasive anterolateral short stem versus transgluteal straight stem cementless total hip arthroplasty: What are the differences in the femoral and pelvic morphology?

Vancouver A	Straight stem (n = 52)	Short stem (n = 12)	P value
Dorr Classification			0.099
A	14 26.9%	0 0.0%
B	28 (53.8%)	9 75%
C	10 ± 19.2%	3 (25%)
AGT	95.4 ± 14.9	107.7 ± 28.4	0.177
Ilium-Ischial ratio	2.95 ± 0.5	2.71 ± 0.4	0.139
Canal flare Index	3.29 ± 0.63	3.21 ± 0.55	0.612
Canal-calcar ratio	0.5 ± 0.09	0.52 ± 0.09	0.352
Canal-bone ratio	0.43 ± 0.07	0.43 ± 0.05	0.816
Morphological Cortical Index	2.7 ± 0.4	2.7 ± 0.48	0.612
Cortical Index	0.57 ± 0.07	0.57 ± 0.05	0.816
Metaphyseal Morphologic Index + 2 cm LT	0.81 ± 0.04	0.81 ± 0.03	0.699
Metaphyseal Morphologic Index Mid-Lesser Trochanter	0.72 ± 0.05	0.72 ± 0.09	0.218
Metaphyseal Morphologic Index −2 cm LT	0.62 ± 0.06	0.61 ± 0.04	0.480
Lateral Metaphyseal CBR (2 cm)	0.67 ± 0.06	0.66 ± 0.06	0.464
Lateral CBR (10 cm)	0.55 ± 0.1	0.57 ± 0.07	0.409
Vancouver B	Straight stem (n = 9)	Short stem (n = 25)
Dorr Classification			1.000
A	1 (11.1%)	4 (16%)
B	6 (66.7%)	17 (68%)
C	2 (22.2%)	4 (16%)
AGT	100.4 ± 8.3	103.4 ± 11.7	0.401
Ilium-Ischial ratio	3.35 ± 0.61	3.05 ± 0.6	0.166
Canal flare Index	2.97 ± 0.7	3.37 ± 0.55	0.191
Canal-calcar ratio	0.54 ± 0.12	0.49 ± 0.07	0.319
Canal-bone ratio	0.49 ± 0.08	0.43 ± 0.06	0.138
Morphological Cortical Index	2.55 ± 0.52	2.67 ± 0.37	0.514
Cortical Index	0.51 ± 0.08	0.57 ± 0.06	0.140
Metaphyseal Morphologic Index + 2 cm LT	0.81 ± 0.08	0.81 ± 0.05	0.876
Metaphyseal Morphologic Index Mid-Lesser Trochanter	0.74 ± 0.08	0.71 ± 0.07	0.585
Metaphyseal Morphologic Index −2 cm LT	0.64 ± 0.06	0.61 ± 0.07	0.226
Lateral Metaphyseal CBR (2 cm)	0.69 ± 0.1	0.66 ± 0.08	0.249
Lateral CBR (10 cm)	0.56 ± 0.04	0.53 ± 0.08	0.226

Vancouver B	Straight stem (n = 9)	Short stem (n = 25)
Dorr Classification			1.000
A	1 (11.1%)	4 (16%)
B	6 (66.7%)	17 (68%)
C	2 (22.2%)	4 (16%)
AGT	100.4 ± 8.3	103.4 ± 11.7	0.401
Ilium-Ischial ratio	3.35 ± 0.61	3.05 ± 0.6	0.166
Canal flare Index	2.97 ± 0.7	3.37 ± 0.55	0.191
Canal-calcar ratio	0.54 ± 0.12	0.49 ± 0.07	0.319
Canal-bone ratio	0.49 ± 0.08	0.43 ± 0.06	0.138
Morphological Cortical Index	2.55 ± 0.52	2.67 ± 0.37	0.514
Cortical Index	0.51 ± 0.08	0.57 ± 0.06	0.140
Metaphyseal Morphologic Index + 2 cm LT	0.81 ± 0.08	0.81 ± 0.05	0.876
Metaphyseal Morphologic Index Mid-Lesser Trochanter	0.74 ± 0.08	0.71 ± 0.07	0.585
Metaphyseal Morphologic Index −2 cm LT	0.64 ± 0.06	0.61 ± 0.07	0.226
Lateral Metaphyseal CBR (2 cm)	0.69 ± 0.1	0.66 ± 0.08	0.249
Lateral CBR (10 cm)	0.56 ± 0.04	0.53 ± 0.08	0.226

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