Health-Related Quality-of-Life and Functional Outcomes in Short-Stem Versus Standard-Stem Total Hip Arthroplasty: An 18-Month Follow-Up Cohort Study

Abstract

BackgroundOsteoarthritis (OA) progressively produces symptoms and disability that may significantly reduce health-related quality of life (HRQoL). Total hip arthroplasty (THA) is an important treatment for symptomatic OA. An alternative to standard-stem THA for younger patients is short-stem THA. The aim of this study was to investigate potential HRQoL and functional outcome differences between these patient groups to provide additional data that will be clinically useful in the decision making between the types of prosthesis.Material/MethodsIn an 18-month follow-up longitudinal cohort study, we conducted Harris Hip Score (HHS) evaluations and SF-36 questionnaires in a study group and a control group undergoing short-stem and standard-stem THA preoperatively and during follow-up at 1, 3, 6, 12, and 18 months. Effect size was calculated to estimate the size of changes in scores during follow-up between chosen time intervals.ResultsA total of 168 patients were included in the study. The total HHS score was significantly increased postoperatively from 46.9 to 87.0 in the standard-stem group, and from 42.7 to 85.1 in the short-stem group. All SF-36 scores improved after THA in both groups. No HRQoL or functional differences were found in the use of either surgical option in the HHS or SF-36 score results (all p>0.05).ConclusionsAs there were no differences in HRQoL in the two groups, we strongly recommend considering short-stem THA, especially in younger patients, due to the benefit of future revision options and a minimally invasive approach.

Sleep improvement after hip arthroplasty: a study on short-stem prosthesis

“…However, the difference in the quality of life after shortstem and standard-stem hip arthroplasty has already been reviewed in several studies that suggest similar functional outcome with slight benefit for short stem prosthesis in younger patients due to faster post-operative recovery as well as less stress shielding [9,10,24,25]. A supplement reduction of thigh pain using short-stem hip arthroplasty might has an effect on sleep improvement, but existing studies show no significant difference compared with conventional standardstem hip arthroplasty [26].…”

“…The current gold standard for hip osteoarthrosis is a total hip replacement [8]. For younger patients with hip osteoarthrosis, the short-stem hip prosthesis is a new method that promises reduced surgical trauma as well as faster post-operative recovery compared with standard-stem prosthesis [9,10].…”

Comparison of Patient-Reported Outcomes of Total Hip Arthroplasty between a Neck-Preserving Short-Stem Implant and a Conventional Neck-Sacrificing Implant

“…4 While one study comparing mediumterm PROs between a different neck-preserving, short-stem implant, and a neck-sacrificing implant reported that there was no significant difference in QOL scores, it still advocated the use of the NPS stem implant in younger patients as it allows for a less-invasive technique and facilitates future revision. 38 A limitation of this study is the low level of evidence, as this was a nonrandomized and nonblinded cohort study. However, the findings observed are promising and serve as a basis for potential future randomized controlled trials.…”

Large prospective validation and cultural adaptation of the Polish version of the Swiss Spinal Stenosis Questionnaire for patients with lumbar spinal stenosis

“…The categories of health tested included physical functioning (PF), role limitations due to physical health problems (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social functioning (SF), role limitations due to emotional problems (RE), and general mental health (MH) [12][13][14].…”