Survivorship and Outcomes of Femoral Neck Preserving Stems in Primary Total Hip Arthroplasty

Reddy, Gireesh B.; Haziza, Sagie; Constantinescu, David S.; Pagan, Dianne N.; Schneiderbauer, Michaela; Robinson, Raymond P.; Hernández, Victor H.

doi:10.1016/j.arth.2022.03.080

Cited by 1 publication

(1 citation statement)

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“…The radiographs were evaluated for changes in implant positioning, stem subsidence (defined as stem migration relative to the greater trochanter), 9) and lateral femoral hypertrophy of the stem tip. 10) The stem position was determined by an angle change of more than 3°, comparing the angle of the AP prosthetic neck-femoral shaft with the angle of the prosthetic stem. 11) …”

Section: Methodsmentioning

confidence: 99%

Midterm Comparative Analysis of Short Femoral Stem Survivorship in Dorr Type A Femurs

Hong,

Han

2024

Clin Orthop Surg

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Background Proximal-distal mismatch has emerged as a prominent concern in Dorr type A femoral morphology, prompting the exploration of short stems as promising alternatives to conventional stems. This study aimed to evaluate clinical and radiographic outcomes of total hip arthroplasty (THA) using short femoral stems in Dorr type A proximal femoral morphology with a minimum follow-up of 5 years. Methods Patients with short femoral stems in Dorr type A between 2011 and 2017 were included. Patients with the Short Modular Femoral (SMF) stem and Metha stem were recruited and patients with a shortened tapered stem (Tri-Lock BPS) were matched by propensity score matching based on age, sex, body mass index, calcar to canal ratio, and diagnosis. Patient-reported outcomes and the presence of thigh pain were assessed at 5 years postoperatively. Revision rate, complication rate, and radiographic outcomes were also assessed and compared. Results Twenty-two cases (81%) in the SMF stem and 43 cases (65%) in the Metha stem had more than 5 years of follow-up data available. The SMF stem showed a higher failure rate than the other 2 groups, with 18% requiring revision surgery in the SMF stem compared to 4.6% in the Metha stem, and 2.3% in the Tri-Lock BPS. The SMF stem showed considerable complications such as stem position change and lateral cortical hypertrophy with inferior clinical outcomes than the other 2 stem groups. When the Metha stem and the Tri-Lock BPS groups were compared, more intraoperative fractures were observed in the Metha stem, whereas stress shielding and anterior thigh pain were significantly more prevalent in the Tri-Lock BPS. Conclusions The SMF stem might be less reliable than previously reported, showing a high failure rate and increased radiologic complications. Thus, its use for THA in Dorr Type A femurs needs caution. On the other hand, the Metha stem showed comparable outcomes to the shortened tapered Tri-Lock BPS.

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Section: Methodsmentioning

confidence: 99%