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Long-term outcomes of the mayo conservative hip system in patients aged 30 years or less with osteonecrosis of the femoral head: mean follow-up of more than 10 years

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

Abstract

Introduction

Historically, total hip arthroplasty (THA) in very young patients has been associated with lower survivorship. However, the long-term outcomes of THA using short stems for osteonecrosis of the femoral head (ONFH) in very young patients remain unclear. Therefore, this study aimed to investigate the long-term outcomes of the Mayo conservative hip system, a short metaphyseal stabilised stem, in patients with ONFH aged ≦30 years.

Materials and Methods

We retrospectively reviewed 104 joints in 76 patients with ONFH who underwent THA using the Mayo conservative hip system with a minimum follow-up of 8 years. The mean follow-up period was 12.5 (range, 8–19) years. Patients were categorised into two age groups (≦30 years, n = 21 and > 30 years, n = 83). Radiographic evaluation was used to assess stem sinking, stress shielding, and spot welds. The clinical evaluations were performed using the Japanese Orthopedic Association (JOA) hip score. Postoperative major complication and revision surgery rates were also assessed.

Results

The patient characteristics were similar between the two groups, except for the age. Revision surgeries were performed in five cases, with similar implant survival rates between the groups. Dislocations occurred in the older age group alone (four joints). One case of intra-operative periprosthetic femoral fracture was found in the younger age group. Stem sinking of > 3 mm occurred in one and seven joints in the younger and older age groups, respectively. Spot welds were observed in most joints (93.2%) in modified Gruen zones 2 and 6 without significant differences between the groups. Stress shielding showed no significant differences in the frequency of occurrence or location between the two groups. Furthermore,the JOA score showed no significant difference between the two groups.

Conclusion

The use of short stems in patients aged ≤ 30 years with ONFH showed favourable long-term outcomes.

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Data availability

Data supporting the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors extend our heartfelt thanks to Dr, Tokito Tatuso from Showa University Fujigaoka hospital for their invaluable assistance in data collection, which significantly contributed to this study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan

    Masanori Nishi, Takashi Atsumi, Yasushi Yoshikawa & Yoshifumi Kudo

  2. Department of Orthopaedic Surgery, Sassa General Hospital, 4-24-15 Tanashicyo, Nishitokyo-shi, Tokyo, 188-0011, Japan

    Masanori Nishi, Takashi Atsumi & Ryosuke Nakanishi

  3. Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-ku, Yokohama City, Kanagawa, 227-8501, Japan

    Ryosuke Nakanishi & Minoru Watanabe

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  1. Masanori Nishi
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  3. Yasushi Yoshikawa
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  4. Ryosuke Nakanishi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Masanori Nishi, Takashi Atsumi, Ryosuke Nakanishi, Yasushi Yoshikawa, and Minoru Watanabe. Yoshifumi Kudo supervised the project. The first draft of the manuscript was written by Masanori Nishi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Masanori Nishi.

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This study was performed in line with the principles of the Declaration of Helsinki. All procedures used in this study were approved by the Ethics Committee of Showa University Hospital.

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Nishi, M., Atsumi, T., Yoshikawa, Y. et al. Long-term outcomes of the mayo conservative hip system in patients aged 30 years or less with osteonecrosis of the femoral head: mean follow-up of more than 10 years. Arch Orthop Trauma Surg (2024). https://doi.org/10.1007/s00402-024-05339-w

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