الفهرس 
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Abstract
Summary
Osteoarthritis (OA) is the most widespread chronic joint disease in the world, defined as common form of arthritis. Failed conservative therapy (hip joint), pain, loss of function, and radiological changes are considered in the decision to achieve total hip replacement
The posterior bow of the proximal femur is just as constant as the mid portion of the anterior bow, but it seems to have beenunrecognized or considered of no importance by most designers of femoral stems. The central portion of the proximal posterior bow is opposite the level of the lesser trochanter. The anterior bow then began talking most of the mid shaft femur, and the anatomical stems were designed based on this anatomical fact.
One of the femoral stem prostheses is anatomical stem that match the proximal femoral endosteal geometry. Stability is achieved through metaphyseal fill and the distal curve. Preparation, consisting of distal reaming and metaphyseal broaching, is less tolerant because of the close match of the shape of the prosthesis to the femoral canal.
The anatomical stem was designed based on the fact that there is a posterior bow in the proximal femur as well as an anterior bow in the shaft. They thought that such a design would be absolutely stable depending on the morphology of the proximal femur. Clinical evaluation of these stems revealed that this idea is not totally correct because of the technically demanding issues during the insertion of such stems and the different varieties of the anatomy of the proximal femur as well as the experience of the surgeon.
The current study of 43 consecutive primary total hip arthroplasties with insertion of an anatomically designed femoral component (exception stem from Zimmer Biomet) without cement. Clinical results were assessed using Harris hipscores. This scores is based on the following parameters: pain, limp, support, distant walked, shoes, stairs, sitting, range of motion, deformity, and public transport.
The study was conducted involving 43 cases in Beni Suef university hospital and in Al-Helal hospital in Cairo who underwent hip arthroplasty using anatomical femoral stem. There were 43 patients including 22 females (51.2%) and 21 males (48.2%). Patients’ ages ranged from 65 years to 74 years with a mean age of 68years.
The Harris hip score was graded into excellent, good, fair and poor - Excellent HHS (≥90): 31 hips (72.09 %)
- Good HHS (80-89): 9 hips (20.9%)
- Fair HHS (70-79): 2 hips (4.65 %)
- Poor HHS (<70): 1 hip (2.3 %)
There were 3 cases with intraoperative calcar cracks which managed with tight circulage wiring, post-operative case with superficial infection which manged with IV and oral AB and one case with DVT.
Post-operative rehabilitation is one of the most important steps of the operation to have the most benefit from surgery to strengthen the abductor muscles and to avoid Trendelenburg gait.
The results of this study demonstratethat the anatomically designed implant deviceprovides the following benefits: The device has wideapplicability that is independent of age and canroutinely be subjected to full weight bearing within the first surgery except in cases with calcar crakes, where they start to weight bear after 6 weeks.
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The learning curve for determining the capacity of a variety of proximal femur to withstand the manner of load application of this stem is shown in the evolution of higher usage. Furthermore, we discovered that when appropriately implanted, the anatomically engineered stem permits patients to resume full weight bearing on the day after surgery
Cementless THA offers good treatmentoption for osteoarthritis hip in the elderly with excellent goodfunctional outcomes. It gives verysatisfactory results that are comparable topublished data. Longer follow up is neededto elaborate stronger clinical and radiological evidence.