Properly designed femoral stem impactors help to avoid overstuffing and make a second trial reduction unnecessary.

Study Summary

50 patients with primary coxarthrosis undergoing cementless total hip arthroplasty (THA) were randomized to receive the Fitmore B stem with the conventional rasp system or the Fitmore B stem with the new optimized rasp system. The outcome of interest was the intraoperative difference in leg length between trial reduction with the stem rasp and reduction with the original implanted stem, measured using a hip navigation system. Other outcomes of interest included femoral offset difference, cup inclination, cup anteversion, and operative characteristics. Outcomes were assessed intraoperatively. Overall, the results of the study revealed that the conventional rasp system had greater mismatch between the trial rasp and original stem than the optimized rasp system, although the between-group difference was not statistically significant. These findings suggest that optimized rasp design may improve the reproducibility of trial reduction and may help avoid unnecessary second trial reduction after implantation of the original stem.