Clinical and radiological short-term results for a calcar-guided short stem : multicentre study of 879 cases

Abstract

A variety of short stems have recently been introduced. The purpose of this study was to evaluate rates and reasons for revision, as well as postoperative short-term radiological and clinical results, after implantation of a short stem of the newest generation in short stem total hip arthroplasty.

In this prospective multicenter study, 879 total hip arthroplasties, using the optimys short stem combined with a cementless cup with a mean follow- up time of 27.3 months (standard deviation SD 7.9), and identical postoperative regimens with full weight bearing, were included. Complications and revisions were documented. Pre- and postoperative radiographs were obtained using a standardized technique. Radiographic alterations were analysed. Pre- and postoperatively, Harris hip score (HHS), rest pain, load pain and satisfaction using the visual analogue scale (VAS) were assessed.

In 13 cases (1.5 %) stem-related revision surgery was needed, five cases (0.6 %) of these involved treatment for aseptic loosening. In 2.2% of cases, radiolucent lines were observed at the prosthesis bone interface. HHS improved from a mean of 46.7 (SD 15.3) preoperatively to 95.7 (SD 8.7) (p < 0.0001) at last follow-up, with 94.1 % excellent or good results. Patient satisfaction using VAS improved from 2.7 (SD 2.4) to 9.6 (SD 1.1) (p < 0.0001). Rest pain and load pain decreased from 4.5 (SD 2.7) to 0.2 (SD 0.8) (p < 0.0001) and 7.4 (SD 1.9) to 0.5 (SD 1.3) (p < 0.0001), respectively.

The investigated meta-diaphyseal anchoring, calcar- guided short stem provides reliable radiological and clinical results in the short-term.