Comparing gait analysis and functional outcomes of short femoral metaphyseal stem and high functional hip arthroplasty (resurfacing and big femoral head): A pilot study

Karampinas, Panagiotis Κ.; Vlamis, John; Papadelis, Eustratios A.; Pneumaticos, Sp.

doi:10.1016/j.jajs.2017.02.005

Cited by 1 publication

(2 citation statements)

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“…2 provided non-comparable data but demonstrated no difference in outcomes between short and conventional stems. 28,33 6 studies reported a higher WOMAC score as worse. A random effects model was applied as I 2 was 56% and a Z-test used for analysis.…”

Section: Comparison Of Womac Index Scoresmentioning

confidence: 99%

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A comparison of patient-reported outcome measures (PROMs) between short and conventional stem hip replacements: a systematic review and meta-analysis

et al. 2019

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Introduction: Short stem hip replacements may allow preservation of proximal bone stock and minimise soft tissue disruption, easing future revision surgery. However patient satisfaction with these implants must be determined before widespread use. We aimed to compare patient reported outcome measures (PROMs) between short and conventional stem hip replacements. Methods: A systematic review was conducted according to PRISMA guidelines for studies comparing short and conventional stem hip replacements with validated PROMs. Meta-analyses were performed for studies reporting Harris Hip and WOMAC scores. Study bias was assessed with the Cochrane Risk of Bias tool and Newcastle-Ottawa Scale. Results: 24 studies, incorporating 2593 total hip replacements were included for qualitative analysis. 17 studies were included in the meta-analyses. Of the 7 excluded, 1 study reported the Japanese Orthopaedic Association score and 2 others reported the Oxford Hip score. All three showed no difference between the stems. A meta-analysis of 17 studies reporting Harris hip scores showed no statistically significant difference between short and conventional stems (standard mean difference (SMD) −0.06, 95% CI −0.20—0.07, p = 0.35). 6 studies reported WOMAC scores with higher scores indicating worse outcome. No difference was seen between the two groups (SMD 0.21, 95%CI, −0.01—0.42, p = 0.06). 4 studies reported higher WOMAC scores as better. Once again, a meta-analysis showed no statistically significant difference between the stems (SMD 0.28, 95% CI −0.07—0.63, p = 0.12). Conclusions: Our systematic review showed no difference in PROMs between short and conventional stem total hip replacements. This is in keeping with previous evidence but is a more comprehensive analysis. Short stems may have an important role in younger individuals as they allow preservation of proximal femoral bone, minimal access surgery and are amenable to abnormal anatomy. The current literature is hindered by non-uniform methodologies and outcome assessments across studies. Further, standardised, high quality evidence is required before widespread changes in practice.

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Section: Comparison Of Womac Index Scoresmentioning

confidence: 99%

“…Individually all 4 showed no statistical difference in HHS between short and conventional stems. 22,25,28,33 Therefore, 17 studies presented the necessary data for meta-analysis, representing 1926 total hip replacements. A random effects model was applied as heterogeneity testing revealed an I 2 value of 52%.…”

Section: Comparison Of Harris Hip Scoresmentioning

confidence: 99%