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Short stems effective for femoral fixation at 3-year mark, study finds
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Successful femoral fixation can be achieved at a minimum 3-year follow up while using a short stem for total hip replacement, according to a recently presented study.
Victor Manuel Ilizaliturri Sanchez, Jr., MD, presented his team’s findings at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons in San Diego.
“There are some theoretical advantages to the use of short, uncemented stems,” Sanchez said, noting reduced invasiveness on the medullary canal and increased physiologic load transfer to the proximal femur, as well as ease of use.
Sanchez and his team analyzed findings from a consecutive series of 56 patients operated on between August 2006 and January 2008. All patients had unilateral hip pathology and were treated with primary total hip replacement (THR) using a short uncemented stem design.
The team collected preoperative and minimum 3-year follow-up WOMAC scores, as well as preoperative and final follow-up radiographs – which were analyzed by an independent observer looking for component migration or loosening.
Average age in the cohort was 48.46 years, with 52% of patients having Dorr type A bone and the other 48% having Dorr type B bone. Forty-four patients, Sanchez reported, received a large metal-on-metal joint with the 12 patients receiving polyethylene in an uncemented modular cup. Six patients were lost to the 3-year follow-up.
Preoperative and final follow-up WOMAC scores were 40.44 and 91.73, respectively – a difference Sanchez said was statistically significant.
Stem subsidence of less than 2 mm was found in 4 patients, with no evidence of loosening at final follow-up radiographs. Three of the stems were reportedly implanted in varus, showing no migration or loosening at final follow-up. Further, Sanchez added, results indicated no evidence of loosening or migration of any components in the rest of the series at the final follow-up.
“We present 100% survivorship at 3 years, with 10% of patients lost to minimum follow-up,” Sanchez said. “Our short-term results compare well with those of similar stems of standard length … we have no complications specific to the short stem, and these early results should be followed with more results in the longer term.”
Reference:
- Sanchez VMI, Gonzalez B, Ugalde HG, Camacho-Galindo J. Total hip replacement using a short uncemented stem. Paper #360. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19. San Diego.
- Disclosure: Sanchez receives royalties and research or institutional support from Smith & Nephew. He is also a member of the speaker’s bureau for or does paid presentations for – and is a paid consultant for – Biomet and Smith & Nephew.
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