Femoral neck preservation with a short hip stem produced with powder manufacturing: mid-term results of a consecutive case series
- 17 Downloads
Stress shielding and thigh pain are not uncommon after cementless total hip arthroplasty (THA) using conventional hip stems. It has been postulated that short, neck-preserving stems may overcome these disadvantages of standard stems and, hence, further improve clinical outcome. The purpose of our retrospective study was to assess the mid-term performance of a neck-preserving hip stem for which, as of yet, no clinical results have been published. A population of 146 consecutive patients who received 152 neck-preserving stems over a 1.6-year period was retrospectively reviewed. Harris Hip Score (HHS) and the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) were collected, along with radiographic data. One hundred and forty-four THAs implanted in 136 patients were available for analysis. After a mean follow-up of 56 months, mean HHS and WOMAC improved significantly versus preoperative values. Aseptic loosening was not observed. Five-year survival with revision of any component for any reason as the endpoint was 99.3% (95% confidence interval, 95.2–99.9%). Excellent mid-term clinical and radiographic outcomes were observed with the study device. We attribute this to the metaphyseal fit in combination with retention of the femoral neck. However, our findings need to be confirmed by multicentre studies with larger patient samples.
KeywordsClinical outcome Minimally invasive surgery Neck preservation Osteoarthritis Total hip arthroplasty
Funding for manuscript development was provided by Adler Ortho, Cormano, Italy. The sponsor had no involvement in the writing of the report or in the decision to submit the results for publication.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics committee approval was obtained prior to study commencement.
Informed consent was obtained from all individual participants included in the study.
- 4.Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop Relat Res 235(235):148–165Google Scholar
- 6.Worlicek M, Weber M, Craiovan B, Wörner M, Völlner F, Springorum HR, Grifka J, Renkawitz T (2016) Native femoral anteversion should not be used as reference in cementless total hip arthroplasty with a straight, tapered stem: a retrospective clinical study. BMC Musculoskelet Disord 17:399CrossRefGoogle Scholar
- 16.McElroy MJ, Johnson AJ, Mont MA, Bonutti PM (2011) Short and standard stem prostheses are both viable options for minimally invasive total hip arthroplasty. Bull NYU Hosp Jt Dis 69(Suppl 1):S68–S76Google Scholar
- 20.Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840Google Scholar
- 21.Gruen T, McNeice G, Amstutz H (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27Google Scholar
- 33.Ollivier M, Parratte S, Galland A, Lunebourg A, Argenson JN (2015) Are titanium-on-titanium TiAl6V4 modular necks safe in total hip arthroplasty for non-overweight patients? Results of a prospective series at a minimum follow-up of 7 years. Eur J Orthop Surg Traumatol 25(7):1147–1152CrossRefGoogle Scholar