Could Short Stems THA Be a Good Bone-Saving Option Even in Obese Patients?

Abstract

Short femoral stems, with preservation of the femoral bone stock, are commonly used in recent years for hip replacement in younger and more active patients. Obesity is increasingly spreading even in the younger population. The aim of this case-series study is to evaluate short stems compared to traditional hip prostheses in the obese population. A total of 77 consecutive patients with a BMI greater than or equal to 30 Kg/m2 were enrolled in this prospective study and were divided into two groups: 49 patients have been implanted with short stems while 28 patients were implanted with traditional stems. All the patients were treated for primary osteoarthritis or avascular necrosis and all the stems were implanted by the same surgeon using a posterior approach. Clinical (Harris Hip Score—HHS, Western Ontario and McMaster Universities Osteoarthritis Index—WOMAC, visual analogue scale—VAS, 12-item Short Form Health Survey—SF-12) and radiographic outcomes were recorded. Radiological evaluations were carried out by three different blinded surgeons. A statistical analysis was performed (chi-square, t-test, Wilcoxon Rank Sum Test, 2-factor ANOVA). At a mean follow-up of 42.6 months both groups showed a marked improvement in pain and in the clinical scores between pre- and post-surgical procedures (p < 0.05) with no significant differences between the two groups at last follow-up (p > 0.05). The radiological evaluations, with high concordance correlation between the three blinded surgeons (ICC consistently >0.80), showed good positioning and osseointegration in all cases, with no significant differences in the restoration of the joint geometry and complications. No revisions were recorded during the follow-up period. In conclusion, short stems appear to be a good option for bone preservation even in obese patients, showing comparable results to traditional implants.

Short stem hip arthroplasty with the optimys prosthesis is a safe and effective option for obese patients: a mid-term follow-up multicenter study

“…However, this can increase the heterogeneity of our study cohort, since patients’ activity levels can differ with age. Nevertheless, the mean age of both cohorts is comparable with other studies investigating the effect of obesity in short stem THA [ 33 , 34 , 36 ]. In addition, the multicenter study design can decrease the homogeneity of the study cohort because of different acetabular cups used and different surgeons who performed the implantation.…”

“…However, there are only limited and partly inconclusive data about the effect of obesity in short stem THA, especially on mid-term and long-term outcomes [ 33 – 36 ]. This is why, the purpose of this study was to a investigate the effect of obesity in short stem THA with the optimys implant on operation characteristics, complications, revision surgeries, and clinical outcome, such as postoperative pain, patient satisfaction, and Harris Hip Score.…”

Early Clinical and Radiographic Outcomes of Total Hip Arthroplasty with DELTA ST-C Cup and MINIMA S Stem

“…The distal surface has a macro roughened surface that is obtained by blasting with a controlled flow of corundum particles [ 12 ]. Following the findings that the diaphyseal tract of a traditional femoral component was no longer necessary to implant stability, once proximal fixation was achieved, the MINIMA S femoral stem was created as part of the efforts made to develop short femoral solutions [ 21 , 22 , 23 , 24 , 25 , 26 ].…”

Tenoplasty in suspension with or without tendon interposition: A prospective randomized study in the treatment of advanced thumb carpometacarpal arthritis

“…The patient's pain was evaluated using the Numeric Pain Rating Scale (NPRS), 10 a segmented numerical version of the Visual Analog Scale (VAS). 11 …”