Early-term clinical and radiographic outcomes of a new short cementless stem for primary total hip arthroplasty in young and active patients.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42158033.
- Also identified by DOI 10.1002/jeo2.70729 and PMC identifier 13182826.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
To evaluate implant survivorship, complication rates and clinical and radiographic outcomes of a novel cementless short femoral stem used in primary total hip arthroplasty (THA). This monocentric retrospective study included 200 consecutive patients younger than 65 years undergoing primary unilateral THA with a cementless short femoral stem and a minimum follow-up of 2 years. All procedures were performed by a single fellowship-trained surgeon using a posterolateral approach. Clinical outcomes were assessed using the modified Harris Hip Score (mHHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS). Radiographic analysis included stem alignment, subsidence, fixation, stress shielding, radiolucent lines (RLLs), cortical hypertrophy and heterotopic ossification. Implant survivorship was estimated using Kaplan-Meier analysis, with revision for any cause as the endpoint. At a mean follow-up of 36.2 months (range: 24.0-44.0), stem survivorship was 100.0%, with no femoral components revised. One patient (0.5%) underwent head exchange for instability. Complication and reoperation rates were 1.5% and 1.0%, respectively. No femoral fractures, subsidence or aseptic loosening were observed. All clinical scores improved significantly: mHHS increased from 67.6 to 97.8, WOMAC from 60.5 to 1.5 and VAS from 7.6 to 0.3 (<i>p</i> < 0.0001). Return to sport was achieved in 85.0% of patients. Radiographically, 11.0% of stems were in varus and 5.0% in valgus. RLLs <2 mm occurred in 23.0% of cases without loosening. Stress shielding was limited (Grade I-II in 15.0%), cortical hypertrophy occurred in 4.0% and spot welds in 32.0% of patients. This short femoral stem demonstrated excellent early survivorship with reliable metaphyseal fixation and low complication rates, supporting its use as a safe bone-preserving option in young and active patients. Level IV.