Literature DB >> 30523465

The learning curve following adoption of a novel short-stem prosthesis in total hip arthroplasty: implications on short-term patient outcomes.

Jorge A Padilla1, Afshin A Anoushiravani2, James E Feng1, Ran Schwarzkopf3, James Slover1, Scott Marwin1.   

Abstract

BACKGROUND: Short-stem (SS) hip prostheses for total hip arthroplasty (THA) have gained popularity as surgeons strive to reproduce physiological stress distributions at the proximal femur. Additionally, as THA indications continue to target younger populations, preservation of femoral bone stock for potential revision surgeries is particularly appealing. However, little is known regarding the short-term complications of each variety of short stem during the learning curve period. The purpose of this study is to evaluate the short-term complications among the THA recipients with the use of a novel SS hip prosthesis.
METHODS: A retrospective chart review was performed of all patients undergoing primary THA utilizing an Echo Bi-Metric Microplasty hip stem. Patient demographics, surgical factors, complications and quality outcomes were collected utilizing our institution's data warehouse and verified by chart review.
RESULTS: In total, 182 SSs were implanted in 168 patients undergoing primary THA. Of these, 5 (2.9%) patients sustained a periprosthetic fracture. Two fractures occurred during the index hospital admission, and 3 occurred in the post-discharge period. Subset analysis demonstrated that 4 (80%) fractures had occurred during the initial learning curve period, within the first 30 surgical cases with a SS.
CONCLUSION: Short-stem hip prostheses are a safe alternative for THA. The results of the present study demonstrate a fracture incidence of 2.9% among patients. However, surgeons should remain cautious when utilizing new implant system and expect a learning curve. In this study, 80% of periprosthetic fractures following SS THA occurred within the first 30 cases for experienced arthroplasty-trained surgeons.

Entities:  

Keywords:  Dual taper; Learning curve; Outcomes; Periprosthetic fracture; Short stem; Total hip arthroplasty

Mesh:

Year:  2018        PMID: 30523465     DOI: 10.1007/s00590-018-2355-z

Source DB:  PubMed          Journal:  Eur J Orthop Surg Traumatol        ISSN: 1633-8065


  31 in total

1.  Strain distribution in the proximal human femur. An in vitro comparison in the intact femur and after insertion of reference and experimental femoral stems.

Authors:  Y H Kim; J S Kim; S H Cho
Journal:  J Bone Joint Surg Br       Date:  2001-03

2.  Results of a tapered cementless femoral stem implanted in varus.

Authors:  Cyna Khalily; D Kevin Lester
Journal:  J Arthroplasty       Date:  2002-06       Impact factor: 4.757

3.  Warning! Dangerous curve ahead: the learning curve.

Authors:  Leon Morgenstern
Journal:  Surg Innov       Date:  2005-03       Impact factor: 2.058

4.  Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030.

Authors:  Steven Kurtz; Kevin Ong; Edmund Lau; Fionna Mowat; Michael Halpern
Journal:  J Bone Joint Surg Am       Date:  2007-04       Impact factor: 5.284

Review 5.  A short stem solution: through small portals.

Authors:  Adolph V Lombardi; Keith R Berend; Joanne B Adams
Journal:  Orthopedics       Date:  2009-09       Impact factor: 1.390

6.  Lateral insufficiency fractures of the femur caused by osteopenia and varus angulation: a complication of total hip arthroplasty.

Authors:  T J Gill; J B Sledge; R Orler; R Ganz
Journal:  J Arthroplasty       Date:  1999-12       Impact factor: 4.757

7.  [Two-year results of a modular short hip stem prosthesis--a prospective study].

Authors:  A Braun; A Sabah
Journal:  Z Orthop Unfall       Date:  2009-10-13       Impact factor: 0.923

8.  When does the 'learning curve' of innovative interventions become questionable practice?

Authors:  P Healey; J Samanta
Journal:  Eur J Vasc Endovasc Surg       Date:  2008-06-30       Impact factor: 7.069

9.  An in vitro study of the strain distribution in human femora with anatomical and customised femoral stems.

Authors:  P O Østbyhaug; J Klaksvik; P Romundstad; A Aamodt
Journal:  J Bone Joint Surg Br       Date:  2009-05

10.  The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years.

Authors:  David Cella; Susan Yount; Nan Rothrock; Richard Gershon; Karon Cook; Bryce Reeve; Deborah Ader; James F Fries; Bonnie Bruce; Mattias Rose
Journal:  Med Care       Date:  2007-05       Impact factor: 2.983

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  4 in total

1.  Does femoral stem choice influence fracture type or incidence for direct anterior approach total hip arthroplasty?

Authors:  Dylan B Combs; Scott T Nishioka; Samantha N Andrews; Joseph Varcadipane; Cass K Nakasone
Journal:  Arch Orthop Trauma Surg       Date:  2021-11-03       Impact factor: 2.928

2.  Primary outcomes of a femoral neck-preserving stem: a multicentre clinical-radiological analysis at 5-year follow-up.

Authors:  Daniel Godoy-Monzon; Saul Martinez; Javier Perez Torres; Felix Eduardo Avendano Duran; Jose Manuel Pascual; Agustin Maria Garcia-Mansilla
Journal:  Eur J Orthop Surg Traumatol       Date:  2021-05-26

3.  Satisfactory clinical and radiologic outcomes with a new shorter and modular stem for end-stage hip osteoarthritis: an international prospective multicentre pilot study.

Authors:  Riccardo D'Ambrosi; Aldo Toni; Jaroslaw Czubak; Jorge Guadilla; Lawrence Lieber; Ilaria Mariani; Nicola Ursino
Journal:  SICOT J       Date:  2022-04-04

Review 4.  Short Stem for Total Hip Arthroplasty (THA) - Overview, Patient Selection and Perspectives by Using the Metha® Hip Stem System.

Authors:  Bernd Alexander Ishaque
Journal:  Orthop Res Rev       Date:  2022-03-24
  4 in total

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