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Mid-term results of short versus conventional cementless femoral stems in patients with bilateral osteonecrosis of the femoral head

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

This study aimed to compare the clinical and radiographic mid-term results between short and conventional stems.

Methods

Patients with bilateral osteonecrosis of the femoral head (ONFH) who had undergone bilateral staged THAs using short stem in one hip and conventional stem in the contralateral hip were included. The Harris Hip Score (HHS), thigh pain, patient’s joint perception (PJP) and patients’ preferred hip were recorded. Using x-ray, osseointegration and stress shielding were analyzed and compared between stems.

Results

There were 35 cases (70 hips) with the mean age of 46.3 years (25–63), and the mean follow-up was 75.1 months (60–108). HHS was significantly improved in both short and conventional groups (p < 0.001). There was mild thigh pain in 2 cases (5.7%) of the short stem group and 6 cases (17.1%) of the conventional group. With regard to the PJP, we found slightly more natural joint feeling in the short stem group. Of the patients’ preferred hip, 11 cases (31.4%) preferred short stem hip and 6 cases (17.1%) preferred conventional stem hip. The short stem group showed osseointegration mainly in the proximal part. The conventional stem group showed osseointegration mainly in the distal part. We found stress shielding grade 1 in 31 cases (88.6%) and grade 2 in 3 cases (8.6%) in the conventional stem group, whereas only grade 1 in 34 cases (97.1%) in the short stem group.

Conclusions

The clinical results were promising in both short and conventional stems; however, short stem showed less thigh pain, slightly more natural joint feeling (PJP) and more patients’ preferred hip. The short stem provided more favorable results for proximal load transfer and slightly less stress shielding.

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Acknowledgement

The authors wish to acknowledge Dr. Urawit Piyapromdee MD for assisting with the statistical analysis and wish to thank Mr. Jason Cullen for help in finalizing the article.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Chang Phueak Rd, Mueang District, Nakhon Ratchasima Province, 30000, Thailand

    Yingyong Suksathien & Jithayut Suarjui

  2. Department of Orthopaedic Surgery, Amnatchareon Hospital, Muang Amnatchareon, Amnatchareon, 37000, Thailand

    Chakkrit Ruangboon

  3. Department of Orthopaedic Surgery, Phayakkaphum Phisai Hospital, Phayakkaphum Phisai, Mahasarakham, Thailand

    Tossaporn Akkrasaeng

Authors
  1. Yingyong Suksathien
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  2. Jithayut Suarjui
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  3. Chakkrit Ruangboon
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  4. Tossaporn Akkrasaeng
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Correspondence to Yingyong Suksathien.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

This study was approved by the institutional review board in Maharat Nakhon Ratchasima Hospital, Thailand (139/2019).

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Suksathien, Y., Suarjui, J., Ruangboon, C. et al. Mid-term results of short versus conventional cementless femoral stems in patients with bilateral osteonecrosis of the femoral head. Eur J Orthop Surg Traumatol 32, 47–53 (2022). https://doi.org/10.1007/s00590-021-02924-2

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  • DOI: https://doi.org/10.1007/s00590-021-02924-2

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