Femoral neck prostheses: A systematic analysis of the literature

Abstract

Primary total hip arthroplasty (THA) is one of the most successful surgical procedures. Considering the demographic change the use of new ultra-short femoral implants has gained importance especially when treating young patients. Main features are bone conservation, metaphyseal anchoring and thus reducing stress shielding by proximal load transferring. The objective of this study is to give an overview over the subject of femoral neck prostheses. A systematic review was conducted. A total number of 27 publications were taken into this systematic review. Over all, just a few follow-up, biomechanical and radiostereometric studies have been conducted in the past. Still no long-term results (>10 years of follow-up) are available. The available mid-term results indicate unsatisfactory survival rates. Aseptic loosening was the most common reason for revision. Valgus angle and good bone mineral density were considered to be crucial for primary stability of femoral neck prostheses. Register data report a very low percentage of femoral neck prostheses in THA with even more diminishing implantation rates. To conclude, further studies are necessary in order to provide evidence-based recommendations. Currently, due to the inhomogeneous and poor data a reasonable and legitimate recommendation cannot be given.

Cementless femoral neck endoprosthesis SPIRON in men in aspects of clinical status and quality of life in an average 7-year follow-up

“…The authors gave two main conditions for the success of this method: lopsided femoral neck and normal bone density. Tsitlakidis and our conclusions indicate that further observation of patients after femoral stem implantation in hip arthroplasty is necessary and careful selection of patients for this type of surgery is important [ 12 ]. In our observation, after the implantation of 34 such endoprostheses, we did not observe the above-mentioned complications.…”

Cementless Femoral Neck Endoprosthesis Spiron in Men in Aspects of Clinical Status and Quality of Life in Average a 5-year Follow-up

“…Tsitlakidis S. et al after analyzing available literature (27 works) on the assessment of the clinical status of patients with osteoarthritis of the hip, in whom the femoral neck endoprothesis was used in the proximal femoral end of the hip revealed, too short average survival of the implant (below 10 years) was foundAs the main reason for failure (revision), the authors pointed to aseptic loosening of the femoral stemand gave two main conditions for the success of this method: lopsided femoral neck and normal bone density [9].Our experience also shows that abnormal femoral neck geometry can affect a higher incidence of aseptic loosening in the early postoperative period. Tsitlakidis and our conclusions indicate that further observation of patients after femoral stemimplantation in hip arthroplasty is necessary and careful selection of patients quali ed for this type of surgery is important.…”

Metal-on-metal metaphyseal and ceramic-on-ceramic femoral neck arthroplasty: the impact on clinical results, oxidative stress and concentration of metal ions in serum and blood

“…Femoral neck arthroplasty systems were invented for younger, active patients, in whom the fact of early implant placement resulted in an increased probability of repeated revision operations in the future. By placing the stem in the femoral neck, they promote physiological load transfer and reduce the stress-shielding phenomenon, leading to the preservation of greater bone mass compared to the use of classic cementless stems [4].…”