Migration Pattern of a Short Femoral Neck Preserving Stem

Röhrl, Stephan M; Li, Ming G.; Pedersen, Elizabeth; Ullmark, Gösta; Nivbrant, Bo

doi:10.1097/01.blo.0000224000.87517.4c

Cited by 78 publications

(57 citation statements)

References 23 publications

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“…In our study we did not observe radiological signs of migration, and no patient complained about thigh pain at the time of follow-up. Other study groups found some early retroversion of the CFP stem that stabilised one year after surgery [8].…”

Section: Discussionmentioning

confidence: 99%

Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis

Briem¹,

Schneider²,

Bogner³

et al. 2010

International Orthopaedics (SICOT)

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Short stem prostheses that preserve the femoral neck are becoming more and more popular. The CFP (collum femoris preserving) has been introduced especially for the treatment of younger patients. However, information about remodelling, complications and learning curve are thus far rare. We present a retrospective study of 155 patients (average age 59.3±9.9 years) who underwent total hip replacement with the CFP prosthesis. Follow-up was obtained 74.3±9.4 months postoperatively. The Harris hip score revealed excellent and good results in 96%. One stem had to be exchanged due to aseptic loosening revealing a survival rate of 99% and 100% for stem and cup, respectively. Radiological analysis showed typical patterns of remodelling with apearance of cortical thickening predominantly in the distal part of the prosthesis. Implant related revision rate was <1%, with further complication rate independent of the surgeon's individual experience. With regard to outcome, survivorship and complication rate, the medium-term results of the CFP prosthesis are promising.

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Section: Discussionmentioning

confidence: 99%

Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis

Briem¹,

Schneider²,

Bogner³

et al. 2010

International Orthopaedics (SICOT)

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“…These findings are of clinical relevance as the association between reconstruction and implant failure is well understood but longer follow ups for short stems are still rare [19,20]. In a RSA migration study Röhrl et al [21], reported on the twoyear results of a short femoral component and concluded that the low migration would suggest a favourably long-term outcome. Lombardi et al [22] published the promising results for a short tapered stem at a mean followup of 7.3 months.…”

Section: Discussionmentioning

confidence: 95%

Does stem design influence component positioning in total hip arthroplasty using a minimal invasive posterolateral approach?

Waldstein

Merle

Schmidt-Braekling

et al. 2014

International Orthopaedics (SICOT)

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Purpose Limited data exist for the reconstructive potential of short bone-preserving stems in THA using a minimal invasive posterolateral approach. Our study aim was to assess the effect of stem design on the reconstruction of hip offset and leg length in MIS posterolateral THA. Methods This retrospective consecutive single-surgeon study compares hip offset and leg length, as well as acetabular component positioning (cup anteversion; inclination) of 129 THAs with a cementless standard-length stem (Synergy®) and 143 THAs with a cementless short bone-preserving stem (Trilock®). Results In reference to the contralateral side, the mean difference in hip offset was 0.9 mm (p=0.067) for the standard stem and 0.1 mm (p=0.793) for the short stem, respectively. Leglength discrepancy was 0.7 mm (Synergy®) and 0.9 mm (Trilock®), respectively. A total of 233 (86 %) acetabular components fell within the target zone for anteversion and inclination. Conclusion Accurate component positioning in MIS posterolateral approach THA is possible and is not influenced by the type of stem.

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“…Furthermore, the implantation of a neck-preserving stem has been shown to generate less contact stress on the medial cortex, than a neck resecting implant [9]. Finally, migration studies have reported that preserving the femoral neck reduces distal migration of the femoral stem [26,42,43].…”

Section: Discussionmentioning

confidence: 99%

“…Reported complications of the CFP stem include undersizing of the stem intra-operatively, recurrent dislocation due to low femoral neck osteotomy, displacement of the stem collar and early retroversion of the stem [42]. The incidence of thigh pain, which can suggest stem micro-motion, has been reported as 0% to 14% [6,39], with one series reporting a residual limp in 9% [31].…”

Section: The Collum Femoris-preserving Stemmentioning

confidence: 99%

Neck-Preserving Femoral Stems

Rajakulendran

Field

2012

HSS Jrnl

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Background: Surgeons undertaking total hip arthroplasty (THA) routinely perform a distal femoral neck resection. It has been argued that retaining the femoral neck during THA can provide mechanical and biological advantages. Purposes: The objectives of this study were to review:(1) the current evidence on the advantages of femoral neck preservation during THA and (2) the clinical and radiological outcome of neck-preserving femoral stems. Methods: A search of the English-language literature on neck-preserving THA and on the individual neck-preserving implants was performed using PubMed, Ovid SP and Science Direct. Results: Studies have indicated that neck preservation offers superior tri-planar implant stability and allows more accurate restoration of the hip geometry and biomechanics. The trend towards tissue sparing surgery has contributed to the development of bone-conserving short-stem implants that offer variable levels of neck preservation. Despite an initial learning curve, these implants have generated promising early clinical results, with low revision rates and high outcome scores. However, radiological evaluation of some neck-preserving implants has detected a characteristic pattern of proximal femoral bone loss with distal cortical hypertrophy. The long-term implications of this finding are not yet known. Conclusions: Preserving the femoral neck during THA has biomechanical advantages. However, long-term outcome data are needed on neck-preserving femoral stems to evaluate on-going bone remodelling and assess implant performance and survival.

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Migration Pattern of a Short Femoral Neck Preserving Stem

Abstract: Therapeutic Level IV. See The Guidelines for Authors for a complete description of levels of evidence.

Cited by 78 publications

References 23 publications

Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis

Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis

Does stem design influence component positioning in total hip arthroplasty using a minimal invasive posterolateral approach?

Neck-Preserving Femoral Stems

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