Low Short-Stem Revision Rates: 1-11 Year Results From 1888 Total Hip Arthroplasties

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• 作者：Christoph Schnurr ; MD^a ; ; Bernd Schellen ; MD^a ; Jens Dargel ; MD^b ; Johannes Beckmann ; MD^c ; Peer Eysel ; MD^b ; Reinhard Steffen ; MD^d
• 关键词：short stem ; survival ; total hip arthroplasty ; aseptic loosening ; fracture
• 刊名：The Journal of Arthroplasty
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：32
• 期：2
• 页码：487-493
• 全文大小：1046 K
• 卷排序：32

文摘

In total hip arthroplasty, short stems were developed as a bone-conserving alternative to traditional cementless stems. So far, there have been very few recorded medium to long-term results of these comparatively new implants. The aim of our retrospective study was to report on the survival of calcar-loading short stems.MethodsAll Metha stem implantations from 2004 to 2014 were recorded from the operation protocols (n = 1888). Due to the chronological development of the stem, 3 different versions were implanted: modular titanium stems with neck adapters from titanium or cobalt-chrome and monoblock stems. Patients were questioned by post about revision, dislocation, and satisfaction.ResultsData were complete for 93% of the procedures (1090 monoblock stems, 314 modular stems with titanium neck, and 230 modular stems with cobalt chrome neck). Mean follow-up was 6 years (1-11 years). Fifteen modular titanium implants were affected by cone fractures (4%). Therefore, monoblock, modular cobalt chrome, and modular titanium implants were analyzed separately. The 7-year revision rate for monoblock stems was 1.5%; for modular cobalt-chrome stems it was 1.8%, and for modular titanium stems it was 5.3%.ConclusionOur data show the midterm survival of the monoblock and modular cobalt-chrome implants equivalent to the traditional cementless stems. These might, therefore, be considered as a bone-conserving alternative for young and active patients.