Abductor Muscle Force after Straight-Stem Compared to Short-Stem Total Hip Arthroplasty through a Modified Direct Lateral Approach: Functional Assessment of 70 Consecutive Patients of a Randomized Controlled Clinical Trial

Abstract

Because of preservation of proximal femoral bone stock and minimized soft tissue trauma, short-stem implants are becoming increasingly important in total hip arthroplasty (THA). The postulated advantage regarding the functional outcome has not been verified. We hypothesized an increased abductor muscle strength by the use of a short-stem design. Seventy consecutive patients of a randomized clinical trial were included. Of these, 67 patients met the inclusion criteria after 12 months. Thirty-five patients received a standard straight stem and 32 patients a short-stem femoral component. All surgeries were performed by a modified direct lateral approach. Isometric muscle strength of the hip abductors was evaluated preoperatively 3 and 12 months after surgery. Harris hip score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. After three months, there were no differences between the two groups; the abductor force was comparable to the preoperative initial values. After 12 months, a significant increase in muscle strength for the short stem patient group compared to preoperative baseline values was measured (straight-stem THA, 0.09 Nm/kg ± 0.4, p = 0.32; short-stem THA, 0.2 Nm/kg ± 0.3, p = 0.004). Comparison of the 12-month postoperative total HHS and WOMAC revealed no significant differences between both groups. A significant increase in hip abductor muscle strength 12 months after short-stem THA compared to conventional-stem THA was observed.

Novel Design of the Compound Sleeve and Stem Prosthesis for Treatment of Proximal Femur Bone Defects Based on Topology Optimization

“…In this study, in order to preserve the distal femoral bone reserve in the femoral cavity, obtain primary stability by biological fixation, and reduce stress shielding and referring to the successful application of porous short-stem prostheses in THA, a novel sleeve prosthesis was designed. Meanwhile, the point of the abductor's muscle could be damaged during bone defect creation, leading to abductor weakness (Fuchs et al, 2021). A sleeve prosthesis could be applied to reconstruct abductor muscle attachment.…”

Effects of Incontro, Alleanza, Responsabilita, Autonomia Intervention Model Combined with Orem Self-Care Model and the Use of Smart Wearable Devices on Perceived Stress and Self-Efficacy in Patients after Total Hip Arthroplasty

“…Nurses assist patients by providing psychological support, technical guidance, and a safe atmosphere. In the meantime, it has reinforced the nurse-patient relationship, increased job satisfaction, improved communication and understanding between the nurse and the patient, and supported the nurse-patient relationship's harmonic development [ 20 ].…”

Short versus conventional straight stem in uncemented total hip arthroplasty: functional outcomes up to 5 years and survival up to 12 years: secondary results of a randomized controlled trial

“…It is supposed to be easier to insert and extract, which might be beneficial for future revisions [ 4 , 5 ]. Possible sparing of soft tissue may accelerate early postoperative rehabilitation and also improve long-lasting functional outcomes [ 6 - 8 ].…”