Bone-preserving total hip arthroplasty in avascular necrosis of the hip—a matched-pairs analysis

  • David Merschin
  • Richard Häne
  • Mersedeh Tohidnezhad
  • Thomas Pufe
  • Wolf Drescher
Original Paper



Short-stem hip arthroplasty has the potential advantage of femoral bone stock preservation, especially in view of the expected revisions in the often relatively young patients. Despite short-stem hip prosthesis are increasingly used for total hip arthroplasty, there are no sufficient mid- and long-term results especially for patients with avascular femoral head osteonecrosis. The present study investigates mid-term functional results as well as the revision rate following implantation of a short-stem prosthesis.


In the period 06/2005 until 12/2013, a total of 351 short-stem hip prostheses were implanted. The study included 331 complete data sets. A retrospective analysis was performed using the Oxford Hip Score. All revisions were registered.


In a total of 331 prostheses, the Oxford Hip Score was “excellent” in 66.2%, “good” in 12.7%, “fair” in 13.0%, and “poor” in 8.2% with a mean follow-up of 57.4 months (SD ± 29.8; range 24–115). In 26 cases, aseptic osteonecrosis of the hip was the indication (7.9%). The Oxford Hip Score was “excellent” in 66.7%, “good” in 0.0%, “fair” in 20.8%, and “poor" in 12.5%. The cumulated five year survival rate was 96.7%.


In mid-term observation, the Metha® short-stem prosthesis shows no disadvantage in functional outcome and in survival time compared to a standard hip stem. Providing a correct indication, the Metha® short stem is a valuable option in total hip arthroplasty for younger patients with avascular osteonecrosis of the femoral head. Evaluation has shown no significant differences between aseptic osteonecrosis and other indications.


Short-stem hip arthroplasty Avascular necrosis Hip 


Compliance with ethical standards

The study has been approved by the Ethic Committee of the Friedrich-Alexander-Universität Erlangen-Nürnberg (Application No.: 330_15 B) and has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. Furthermore, the study has been performed in accordance with the regulations of the US Health Insurance Portability and Accountability Act (HIPAA).

Conflict of interest

David Merschin, Richard Häne, Thomas Pufe, and Mersedeh Tohidnezhad do not have any conflict of interest. Wolf Drescher works as a consultant for Zimmer Biomet and as an instructor for B. Braun Aesculap.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • David Merschin
    • 1
  • Richard Häne
    • 2
  • Mersedeh Tohidnezhad
    • 3
  • Thomas Pufe
    • 3
  • Wolf Drescher
    • 2
  1. 1.Clinic for Trauma Surgery and OrthopaedicsBG Klinikum Unfallkrankenhaus BerlinBerlinGermany
  2. 2.Department of Orthopaedic Surgery of the Lower Limb and ArthroplastyHospital RummelsbergSchwarzenbruckGermany
  3. 3.Institut für Anatomie und ZellbiologieUniklinik RWTH AachenAachenGermany

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