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A neck-preserving short stem better reconstructs the centre of rotation than straight stems: a computed tomography-based cadaver study

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Short femoral hip stems with a metaphyseal anchoring concept have been designed to treat younger patients with good bone quality. The aim of this study was to reconstruct the centre of rotation and soft tissue balancing and preserve bone in the long-term perspective.

Materials and methods

Eighteen human femurs were randomised into three groups: (1) metaphyseal anchoring short stem, (2) shortened straight stem, (3) straight stem). Prior to the implantation of the hip stems, a computed tomography (CT) of the bones was performed and the femoral ante-torsion and ante-tilt was measured and compared to the results of the post-implantation CT. This could be calculated based on the 3D coordinates taken from the pre- and post-op CT scans, which were transformed into the same coordinate systems.

Results

The mean preoperative caput–collum–diaphyseal (CCD) angle for the three groups was 126.87° ± 3.50° (Group 3: 129.64° ± 3.53°, Group 1: 123.76° ± 5.56°, Group 2: 127.53° ± 1.42°) and was consistent with published reports. The postoperative CCD angles with 126.85° ± 3.43° were within a very good reconstruction range for all three groups.

The anterior offset comparison among these three groups showed significant difference in reconstruction. The smallest difference between the anatomical (preoperative) and postoperative condition was seen in Group 1 (1.47° ± 0.60°), followed by Group 2 (3.60° ± 0.23°) and Group 3 (8.00° ± 0.70°) groups. The horizontal offset showed no significant difference among the groups and was within the window of ± 5 mm.

Conclusion

In this cadaver study, we found that the metaphyseal anchoring, partially neck-preserving short hip stem best reconstructs the ante-torsion and the ante-tilt of the femoral neck. Therefore, it can be a useful stem in younger or active middle-aged patients.

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Acknowledgements

None declared.

Funding

This study was financed by Aesculap AG and has not been presented in any conference before.

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Authors and Affiliations

  1. Vincenz Krankenhaus Paderborn, Standort Salzkotten, Dr.-Krismann-Strasse 12, 33154, Salzkotten, Germany

    M. Ezechieli

  2. Orthopaedic Clinic Medical School Hannover, Hannover, Germany

    M. Ezechieli, H. Windhagen, S. Budde & N. Wirries

  3. Nissan Tamagawa Hospital, Tokyo, Japan

    M. Matsubara

  4. Expert and Product Management Department, BBraun Aesculap, Tuttlingen, Germany

    M. Sungu

Authors
  1. M. Ezechieli
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  2. H. Windhagen
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  3. M. Matsubara
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  4. S. Budde
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  5. N. Wirries
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  6. M. Sungu
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Corresponding author

Correspondence to M. Ezechieli.

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Conflict of interest

Authors ME, SB, and HW received grants from Aesculap AG, Tuttlingen, Germany, where they are medical consultants. Author MS is an engineer and employee at Aesculap AG, Tuttlingen, Germany. Authors MM and NW have no conflict of interest to declare.

Ethical approval

This article describes a cadaveric study and does not contain any studies/experiments on live human subjects or animals.

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This article does not contain any studies with human participants and hence, no informed consent was required from individual participants.

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Ezechieli, M., Windhagen, H., Matsubara, M. et al. A neck-preserving short stem better reconstructs the centre of rotation than straight stems: a computed tomography-based cadaver study. Arch Orthop Trauma Surg 142, 1669–1680 (2022). https://doi.org/10.1007/s00402-021-03957-2

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  • DOI: https://doi.org/10.1007/s00402-021-03957-2

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