Short Uncemented Femoral Stems in Total Hip Arthroplasty
Marco Aurélio Silvério Neves1*, Leandro Gregorut Lima1, Gustavo Rocha Santos1, Kelly Cristina Moutinho da Costa1, Thais Cristina Rampazo1 and Barbara Fialho Carvalho Sampaio1,2
1Arthron Specialized Medical Service, Brazil
2University of São Paulo School of Medicine, Brazil
*Corresponding Author: Marco Aurélio Silvério Neves, Arthron Specialized Medical Service, Brazil.
June 30, 2022; Published: September 30, 2022
Total hip arthroplasty with short stems has been increasingly used in the treatment of hip degenerative diseases. Total hip arthroplasty with short stems can preserve bone stock and are a good choice in young patients who will eventually undergo revision surgery. It is also a good choice when we use approaches for minimally invasive surgeries. In this study, we evaluated clinically and radiologically our cases of total hip arthroplasty with Proxima® short rods (DePuy). Patients were assessed clinically using the Harris Hip Score (HHS). We included in the study a total of 82 hips (77 patients) with mean age of 52 years at the time of surgery. These patients were followed for at least 5 years. There was a slight femoral deviation in Varo from the stem in two cases, with no asseptic loosening. We observed three cases with migration of the femoral component with consequent subsidence in the femoral canal, requiring revision. The metaphyseal stem has good results in most cases, but our experience with this implant demonstrates that it demands more technically from the surgeon and from the bone conditions of the patient.
Keywords: Total Hip Arthroplasty; Metaphyseal Stems; Degenerative diseases
- Buergi ML., et al. “Radiological findings and clinical results of 102 thrust-plate femoral hip prostheses: a follow-up of 2 to 8 years”. The Journal of Arthroplasty 1 (2005): 108-117.
- Morrey BF. “Short-stemmed uncemented femoral component for primary hip arthroplasty”. Clinical Orthopaedics and Related Research 249 (1989): 169-175.
- Thomas W., et al. “ESKA (CUT) endoprosthesis”. Orthopedics 11 (2004): 1243-1248.
- Ishaque BA., et al. “Midterm results and revisions of the thrust plate prosthesis (TPP)”. Zeitschrift fur Orthopadie und ihre Grenzgebiete 1 (2004): 25-32.
- Fink B., et al. “Short- and medium-term results of the thrust plate prosthesis in patients with polyarthritis”. Archives of Orthopaedic and Trauma Surgery 5-6 (2000): 294-298.
- Renkawitz T., et al. “A new short uncemented, proximally fixed anatomic femoral implant with a prominent lateral flare: design rationals and study design of an international clinical trial”. BMC Musculoskeletal Disorders 9 (2008): 147.
- Learmonth ID. “Conservative stems in total hip replacement”. HIP International 3 (2009): 195-200.
- Hube R., et al. “Early functional results with the Mayo-hip, a short stem system with metaphyseal-intertrochanteric fixation”. Orthopedics11 (2004): 1249-1258.
- Kishida Y., et al. “Preservation of the bone mineral density of the femur after surface replacement of the hip”. The Journal of Bone and Joint Surgery 2 (2004): 185-189.
- Martell JM., et al. “Primary total hip reconstruction with a titanium fiber- coated prosthesis inserted without cement”. The Journal of Bone and Joint Surgery America 4 (1993): 554-571.
- Engh CA., et al. “Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results”. The Journal of Bone and Joint Surgery 1 (1987): 45-55.
- Engh CA., et al. “A quantitative evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty”. The Journal of Bone and Joint Surgery 7 (1992): 1009-1020.
- Kim YH., et al. “Primary total hip arthroplasty with a second-generation cementless total hip prosthesis in patients younger than fifty years of age”. The Journal of Bone and Joint Surgery America 85-A.1 (2003): 109-114.
- Santori F., et al. “Ultrashort stem with proximal load transfer: Clinical and radiographic results at 4years follow up”. The Journal of Bone and Joint Surgery British 1 (2006): 54.
- Henry JD., et al. “Two- to four-year experience with cemented, press-fit, and porous coated applications of the profile total hip system”. Acta Orthopaedica Belgica 1 (1993): 190-194.
- Donnelly WJ., et al. “Radiological and survival comparison of four methods of fixation of a proximal femoral stem”. The Journal of Bone and Joint Surgery British 3 (1997): 351-360.
- Freeman MA and Plante-Bordeneuve P. “Early migration and late aseptic failure of proximal femoral prostheses”. The Journal of Bone and Joint Surgery British 3 (1996): 432-438.
- Krismer M., et al. “The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-Analyse- femoral component analysis”. The Journal of Bone and Joint Surgery British 2 (1999): 273-280.
- Schmidt R., et al. “A computed tomography assessment of femoral and acetabular bone changes after total hip arthroplasty”. International Orthopaedics 5 (2002): 299-302.
- Sychterz CJ., et al. “What we have learned about long- term cementless fixation from autopsy retrievals”. Clinical Orthopaedics and Related Research 405 (2002): 79-91.
- Ender SA., et al. “Cementless CUT femoral neck prosthesis: increased rate of aseptic loosening after 5 years”. Acta Orthopaedica 5 (2007): 616-621.