Short neck-preserving femoral stem for total hip arthroplasty: medium-term results of a 68-case series.

INTRODUCTION: Short stems seem to be a good alternative for young patients as they offer promising results, rapid recovery and preservation of metaphyseal bone stock. This is one of the few studies in the literature to report medium-term clinical-radiological results for short hip stems. MATERIALS AND METHODS: This prospective study evaluated 68 short femoral stems in 63 patients treated with total hip replacement. Clinical, functional and quality-of-life outcomes were measured at 6 and 12 months, and annually thereafter until the end of follow-up. The radiological analysis included measurements of potential leg length discrepancies, stem alignment and signs compatible with stress shielding. RESULTS: Fifty-four males (59 hips) and nine females (9 hips) of an average age of 44.3 years (range, 25-68) were studied. The most common diagnosis was osteoarthritis (51.5%). Mean overall follow-up was 7.8 years (range, 5.8-9.8). The overall survival rate was 97.1% (95% CI 88.7-99.7%). Surgery resulted in an increase of 42.3 ± 1.1 points in the modified Harris Hip Score and 21.9 ± 0.6 points in the Oxford Hip Score (p < 0.001, respectively). Moreover, the pain score as measured on a numerical rating scale (NRS) improved from 95.8 to 36.3. As regards function, an improvement was observed from 3.2 ± 0.8 points to 6.8 ± 1.14 points on the University of California at Los Angeles activity score (p < 0.001, respectively). The radiological analysis showed an absence of radiolucencies or stress-shielding throughout the series. The complications rate at the end of follow-up was 5.7%. CONCLUSIONS: The use of ultra-short cylindrical stems with complete anchorage in the femoral neck was shown to offer promising medium-term results. Such stems appear to be a good option for young patients, who are likely to require several revisions over their lifetime.

Actualización en artroplastia total de cadera / No disponible

No disponible

Actualización sobre la revisión de las artroplastias totales de cadera / No disponible

No disponible

Actualización en artroscopia de cadera / No disponible

No disponible

Multicentric and prospective study of the Summit cementless stem.

We assess early clinical and radiographic results of a multicentric and prospective study of 485 Summit porous-coated stems implanted in 5 hospitals. Of the patients, 171 had a hydroxyapatite (HA) coating and 314 had non-HA porous-coated stems. The mean follow-up was 4.2 years (range 2.5-6 years). The median size of the stem was 5. A standard femoral offset stem was used in 366 hips (75.5%) and a high femoral offset in 119 hips (24.5%). Dislocation was the most frequent postoperative complication (16 hips). Clinical results according to the Harris scale were 30.17 points (range 10-52) before surgery and 95 points (range 90-100) at the last follow-up evaluation. All stems were radiographically osseointegrated. Femoral stem position was neutral in 395 hips (81.4%), and femoral canal filling was related with implant position. No stem subsidence greater than 5 mm has been found in any hip. No osteolysis was found around the femoral stem. No differences have been found between HA coating and non-HA porous-coated stems. Although the present follow-up in this series is too short to allow definite conclusions, the Summit stem with and without HA coating has provided excellent short-term results.