Long-Term Clinical and Radiographic Results of an Ultra-Short Metaphyseal-Fitting Non-Anatomic Cementless Stem in Patients with Femoral Neck Fracture.

Abstract

The purpose of this study is to determine the clinical and radiographic outcomes, mortality rate, complication rate, and revision rate of this ultra-short non-anatomic cementless femoral stem in elderly patients with a femoral neck fracture. We reviewed the results of 284 total hip arthroplasties performed with an ultra-short non-anatomic cementless stem in 280 previously active patients with a mean age of 72.8 ± 13 years (range 49-83). The mean follow-up was 9.3 years (range 7-13). The mean Harris Hip Score was 86 ± 14 points at final follow-up. The mean Western Ontario and McMaster Universities Osteoarthritis Index score was 24 ± 6 points at the final follow-up. The mean University of California, Los Angeles activity score was 6 points at final follow-up. Osseointegration was seen in all acetabular (100%) and in 276 femoral components (97%). Kaplan-Meier survivorship analysis revealed that the survival rate of the femoral component at 8.3 years was 97% (95% confidence interval 91-100) and that of the acetabular component was 100% (95% confidence interval 94-100) with aseptic loosening or revision as the end point. An ultra-short non-anatomic cementless femoral stem in patients with good bone quality (Dorr A and some Dorr type B bone) is a safe treatment for femoral neck fracture. In patients with poor bone quality (Dorr C type), the results were very poor, and use of this stem should be avoided.