Arnaldo Sousa1,2, João Vale3,4, Sara Diniz3,4, Pedro Neves3,4, Joaquim Ramos3,4, Rafaela Coelho3,4. 1. Hip Unit, Department of Orthopaedics, Centro Hospitalar E Universitário Do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. arnaldosousa5@hotmail.com. 2. Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal. arnaldosousa5@hotmail.com. 3. Hip Unit, Department of Orthopaedics, Centro Hospitalar E Universitário Do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. 4. Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal.
Abstract
PURPOSE: Short-stem prostheses in hip arthroplasty have emerged as an alternative to conventional stems, especially in younger patients. The purpose of this study was to compare functional and radiological results of a short metaphyseal fitting cementless stem versus a conventional stem implant, in patients younger than 60 years. METHODS: All patients operated from January 2006 to April 2013 were included, obtaining a minimum follow-up of 7 years. Harris Hip Score (HHS) and SF-36 (quality of life) questionnaires were applied and the presence of "thigh pain" was specifically assessed. We also compared complication rate, revision rate and average prosthesis survival. Femoral stress shielding (Gruen scale), stem subsidence, varus-valgus tilt and implant stability (Engh scale) were also compared. RESULTS: A total of 101 short-stem and 74 conventional arthroplasties were included, with an average follow-up of 9.82 (7-14) years. HHS functional score and SF-36 were excellent in both implants and no significant difference between them (p > 0.05) was found. However, "thigh pain" was present in 7 patients with conventional stems and none with short-stems (p < 0.001). The survival rate at 13 years was 99%, for both implants, and no significant differences were found between them (χ2(2) = 0.178; p = 0.673). Conventional stems had stress shielding at the greater trochanter in 72% of the cases and 43% at the calcar, being statistically superior (p < 0.001) to the stress shielding observed in the short stems. CONCLUSION: According to our results, this short-stem seems to allow preservation of bone stock, with decreased stress shielding and also a lower incidence of thigh pain compared to conventional stems. LEVEL OF EVIDENCE: Level III retrospective comparative study.
PURPOSE: Short-stem prostheses in hip arthroplasty have emerged as an alternative to conventional stems, especially in younger patients. The purpose of this study was to compare functional and radiological results of a short metaphyseal fitting cementless stem versus a conventional stem implant, in patients younger than 60 years. METHODS: All patients operated from January 2006 to April 2013 were included, obtaining a minimum follow-up of 7 years. Harris Hip Score (HHS) and SF-36 (quality of life) questionnaires were applied and the presence of "thigh pain" was specifically assessed. We also compared complication rate, revision rate and average prosthesis survival. Femoral stress shielding (Gruen scale), stem subsidence, varus-valgus tilt and implant stability (Engh scale) were also compared. RESULTS: A total of 101 short-stem and 74 conventional arthroplasties were included, with an average follow-up of 9.82 (7-14) years. HHS functional score and SF-36 were excellent in both implants and no significant difference between them (p > 0.05) was found. However, "thigh pain" was present in 7 patients with conventional stems and none with short-stems (p < 0.001). The survival rate at 13 years was 99%, for both implants, and no significant differences were found between them (χ2(2) = 0.178; p = 0.673). Conventional stems had stress shielding at the greater trochanter in 72% of the cases and 43% at the calcar, being statistically superior (p < 0.001) to the stress shielding observed in the short stems. CONCLUSION: According to our results, this short-stem seems to allow preservation of bone stock, with decreased stress shielding and also a lower incidence of thigh pain compared to conventional stems. LEVEL OF EVIDENCE: Level III retrospective comparative study.
Authors: Samik Banerjee; Robert Pivec; Kimona Issa; Steven F Harwin; Michael A Mont; Harpal S Khanuja Journal: Orthopedics Date: 2013-09 Impact factor: 1.390
Authors: Martje N R Althuizen; Miranda L V Hooff; Saskia H M v d Berg-v Erp; Jacques V Limbeek; Marc W Nijhof Journal: Hip Int Date: 2012 Nov-Dec Impact factor: 2.135
Authors: Steven M Kurtz; Edmund Lau; Kevin Ong; Ke Zhao; Michael Kelly; Kevin J Bozic Journal: Clin Orthop Relat Res Date: 2009-04-10 Impact factor: 4.176
Authors: Patrick Reinbacher; Maria Anna Smolle; Joerg Friesenbichler; Alexander Draschl; Andreas Leithner; Werner Maurer-Ertl Journal: Sci Rep Date: 2022-10-13 Impact factor: 4.996