Journal
JOURNAL OF ARTHROPLASTY
Volume 32, Issue 2, Pages 487-493Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2016.08.009
Keywords
short stem; survival; total hip arthroplasty; aseptic loosening; fracture
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Background: 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. Methods: All 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. Results: Data 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%. Conclusion: Our 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. (C) 2016 Elsevier Inc. All rights reserved.
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