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Clinical and radiological outcomes of an uncemented metaphyseal short stem at minimum 10 years of follow-up: a prospective observational study

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

Abstract

Purpose

There is growing interest around short stems as they provide a less invasive approach for total hip arthroplasty preserving bone stock for a possible revision surgery if required. The main purpose of this work was to assess the long-term performance of an uncemented metaphyseal short stem in terms of survival rate and in addition its clinical and radiological outcomes.

Materials and methods

From January to December 2010, we prospectively enrolled all consecutive patients undergoing primary total hip arthroplasty with an uncemented metaphyseal short stem in our institution with a minimum follow-up of 10 years. The radiographic features investigated were the varus–valgus stem orientation, areas of osteolysis and radiolucencies, stress shielding, and heterotopic calcifications. The clinical outcomes were measured using the HHS.

Results

A total of 163 patients (172 hips) were finally included and the measured survival rate at 10 years was 99.6%. The average HHS increased from 55.0 preoperatively to 97.8 at the last follow-up (p < 0.0001). Among them, 137 patients (164 hips) were also available for radiographic assessment. Mild varus malalignment was observed in 40% of cases and remained stable in the serial X-rays and was not associated with step loosening. Mild stress shielding was observed around 13 stems (9%) and moderate only around 3 implants.

Conclusion

In conclusion, the uncemented metaphyseal short stems showed excellent survival and clinical results at 10 years and at a radiographical level very low stress shielding was observed; moreover, besides the high frequency of varus alignment the implanted stems was not associated with revision surgery or with worse clinical outcomes.

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Available data are currently under transfer on a digital data repository that will be available soon.

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Funding

FMG, MS, KC, and EM declare they have no financial interests. ML has received royalties and speaker and consultant honoraria from the company Zimmer Biomet. In addition, he received research funding through a national research grant (GR-2018-12367275) to IRCCS Humanitas Research Hospital, from Italian Ministry of Health. GG has received royalties and speaker and consultant honoraria from the companies Zimmer Biomet, Innomed, and Adler Ortho.

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Authors and Affiliations

  1. IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy

    Guido Grappiolo, Katia Chiappetta, Emanuela Morenghi & Mattia Loppini

  2. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy

    Francesco Manlio Gambaro, Marco Spera & Mattia Loppini

  3. Fondazione Livio Sciutto Onlus, Campus Savona-Università degli Studi di Genova, Via Magliotto 2, 17100, Savona, Italy

    Guido Grappiolo, Katia Chiappetta & Mattia Loppini

Authors
  1. Guido Grappiolo
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  2. Francesco Manlio Gambaro
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  3. Marco Spera
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  4. Katia Chiappetta
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  5. Emanuela Morenghi
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  6. Mattia Loppini
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Contributions

All the authors contributed to the study conception and design. Material preparation, and data collection and analysis were performed by FMG and MS. The first draft of the manuscript was written by ML and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Mattia Loppini.

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Conflict of interest

FMG, MS, KC, and EM have no competing interests to declare that are relevant to the content of this article. ML has received royalties and speaker and consultant honoraria from the company Zimmer Biomet. In addition, he received research funding through a national research grant (GR-2018-12367275) to IRCCS Humanitas Research Hospital, from Italian Ministry of Health. GG has received royalties and speaker and consultant honoraria from the companies Zimmer Biomet, Innomed, and Adler Ortho.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethical Committee of Humanitas Research Hospital (protocol number: 1907, date January 2010).

Consent to participate

Informed consent was obtained from all individual participants included in this study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 2 and 3.

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Grappiolo, G., Gambaro, F.M., Spera, M. et al. Clinical and radiological outcomes of an uncemented metaphyseal short stem at minimum 10 years of follow-up: a prospective observational study. Arch Orthop Trauma Surg 144, 425–431 (2024). https://doi.org/10.1007/s00402-023-05012-8

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  • DOI: https://doi.org/10.1007/s00402-023-05012-8

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