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

Abstract

Purpose

Coxarthrosis is a common disease of the adult hip joint. Elderly patients have mainly been treated with total hip arthroplasty (THA); however, younger patients are increasingly affected. Short-stem prostheses were developed for this special patient group. There have been few studies on the clinical outcomes of this type of prosthesis. This study compared the mid-term results of a short-stem prosthesis and a standard-stem prosthesis 8 years after implantation.

Methods

According to our clinical registry, patients who received a short-stem prosthesis before 2011 were identified. Patients in the standard-stem prosthesis group were matched based on the sex, age, height, weight, and degree of arthrosis. At the follow-up time, the modified Harris Hip Score (mHHS), University of California Los Angeles (UCLA) activity score and visual analog scale (VAS) pain score were collected and compared with the preoperative values.

Results

Fifty-five patients could be matched and analyzed for both groups. No patients needed revision surgery. In both groups, there were significant improvements at the follow-up time. The pre- and postoperative mHHSs, UCLA scores, and VAS scores were 41.9 and 95 (p < 0.0001), 3.75 and 7.9 (p < 0.0001), and 7.6 and 0.9 (p < 0.0001), respectively, in the short-stem group and 44.8 and 96.25 (p < 0.0001), 3.6 and 7.7 (p < 0.0001), and 7.7 and 0.9 (p < 0.0001), respectively, in the control group, with no significant differences between the groups at the follow-up time.

Conclusion

The short-stem prosthesis provides mid-term results comparable to those of a standard-stem prosthesis. In both groups, excellent patient-reported outcomes were achieved after an average of 8 years.

Level of evidence

IV.

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Funding

One of the authors received payment for instructional courses for Arthrex and Richard Wolf.

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Correspondence to Alexander Zimmerer.

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Dr. Zimmerer, Ms. Slouka, Dr. Fritz, Dr. Kinkel and Prof. Weiss report no conflict of interest. Dr. Miehlke reports personal fees from Arthrex, personal fees from Richard Wolf, outside the submitted work. Dr. Sobau reported no conflict of interest.

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This study was approved by IRB/Ethikkommission Landesärztekammer Baden-Württemberg, Germany.

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Zimmerer, A., Slouka, S., Kinkel, S. et al. Comparison of short-stem with conventional-stem prostheses in total hip arthroplasty: an 8-year follow-up study. Arch Orthop Trauma Surg (2020). https://doi.org/10.1007/s00402-020-03519-y

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Keywords

  • Total hip replacement
  • Short stem
  • Outcome
  • Hip pain
  • Hip prosthesis
  • Young patient