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Short-stem hip arthroplasty in osteonecrosis of the femoral head

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

Abstract

Introduction

Osteonecrosis of the femoral head (ONFH) is a locally destructive and complex disorder. Without treatment, infraction of the femoral head is likely. There is also a lack of consensus in the literature about the most appropriate arthroplasty method in patients with progressive ONFH. During the last decade, the number of short-stem prostheses has increased. Some short-stem designs have a metaphyseal anchorage. It is questionable whether ONFH represents a risk factor for failure after implantation of short stems. The aim of this study was to review existing literature regarding the outcome of short-stem arthroplasty in ONFH and to present the pros and cons of short-stem hip arthroplasty in osteonecrosis of the femoral head.

Materials and methods

This review summarises existing studies on short-stem hip arthroplasty in osteonecrosis of the femoral head.

Results

Few studies have analysed the clinical and radiological outcome of short-stem THA in patients with ONFH. Only a handful of studies present clinical and radiological outcome after implantation of a short-stem arthroplasty in patients with the underlying diagnosis of osteonecrosis of the femoral head.

Conclusion

The short- to medium-term results show predominantly good outcomes. However, due to differences in the design of short stems and their fixation, it is hard to draw a general conclusion. Short stems with primary diaphyseal fixation do not reveal a high increased risk of failed osseointegration or loosening. For designs with a primary metaphyseal anchorage, an MRI should be conducted to exclude that the ostenecrosis exceeds the femoral neck.

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Conflict of interest

Three of the authors (TF, HW, GvL) are paid instructors for the company Aesculap.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany

    Thilo Floerkemeier, Stefan Budde, Jens Gronewold, Kerstin Radtke, Max Ettinger, Henning Windhagen & Gabriela von Lewinski

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  1. Thilo Floerkemeier
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  2. Stefan Budde
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Correspondence to Thilo Floerkemeier.

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Floerkemeier, T., Budde, S., Gronewold, J. et al. Short-stem hip arthroplasty in osteonecrosis of the femoral head. Arch Orthop Trauma Surg 135, 715–722 (2015). https://doi.org/10.1007/s00402-015-2195-9

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  • DOI: https://doi.org/10.1007/s00402-015-2195-9

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