The Mayo conservative hip: complication analysis and management of the first 41 cases performed at a University level 1 department

Abstract

BackgroundTo prevent bone loss in hip arthroplasty, several short stem systems have been developed, including the Mayo conservative hip system. While there is a plethora of data confirming inherent advantages of these systems, only little is known about potential complications, especially when surgeons start to use these systems.MethodsIn this study, we present a retrospective analysis of the patients’ outcome, complications and the complication management of the first 41 Mayo conservative hips performed in 37 patients. For this reason, functional scores, radiographic analyses, peri- and postoperative complications were assessed at an average follow-up of 35 months.ResultsThe overall HHS improved from 61.2 pre-operatively to 85.6 post-operatively. The German Extra Short Musculoskeletal Function Assessment Questionnaire (XSFMA-D) improved from 30.3 pre-operatively to 12.2 post-operatively. The most common complication was an intraoperative non-displaced fracture of the proximal femur observed in 5 cases (12.1%). Diabetes, higher BMI and older ages were shown to be risk factors for these intra-operative periprosthetic fractures (p < 0.01). Radiographic analysis revealed a good offset reconstruction in all cases.ConclusionIn our series, a high complication rate with 12.1% of non-displaced proximal femoral fractures was observed using the Mayo conservative hip. This may be attributed to the flat learning curve of the system or the inherent patient characteristics of the presented cohort.

Uncemented short stems in primary total hip arthroplasty

“…The Mayo stem demonstrated a mean survivorship of 95.4% (92.3% to 100%) with aseptic loosening as the endpoint, at a mean follow-up of 4.7 years (2 to 7.9) in 592 hips. 7 , 8 , 40 – 46 The mean HHS was 91 points (85 to 96) at the final follow-up assessment in 592 hips, 7 , 8 , 40 – 46 while the mean incidence of thigh pain was 1.6% (0% to 2.7%) in 250 hips. 8 , 42 , 44 The mean intra-operative peri-prosthetic fracture rate was 6.8% (0% to 12.1%) in 529 hips.…”

“… 8 , 42 , 44 The mean intra-operative peri-prosthetic fracture rate was 6.8% (0% to 12.1%) in 529 hips. 7 , 8 , 40 , 42 , 44 – 46 In two studies including 90 hips, 42 , 46 the authors evaluated the coronal stem malalignment reporting valgus position in 25.5% of the hips and varus position in 31.1%. The mean rate of > 2-mm stem subsidence was 3% (0% to 7%) in 302 hips 8 , 40 , 42 – 44 and the mean rate of stress shielding was 5.6% (4.1% to 6.7%) in 238 hips.…”

Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study

“…Varus or valgus alignment of the stem has been reported in studies investigating short stems, with a rate ranging from 4% to 51% [20,27,28,29,30]. We reported a significantly higher rate of varus position with the GTS than CLS stem (14% versus 6%), even if it was a slightly varus alignment ranging between 3° and 7°.…”

Comparison of short-stem with conventional-stem prostheses in total hip arthroplasty: an 8-year follow-up study

“…The Mayo stem demonstrated a mean survivorship of 95.4% (92.3–100%) with aseptic loosening as the endpoint, at a mean follow-up of 4.7 years (2–7.9). The mean HHS was 91 points (85–96) at the final follow-up assessment in 592 hips [ 8 , 30 – 37 ]. Looking at these results, it can be summarized that the NANOS stem achieves comparable clinical results in a mid-term follow-up.…”