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Analysis of Postoperative Complication and Revision Rates and Mid- to Long-Term Implant Survival in Primary Short-Stem Total Hip Arthroplasty

Overview
Journal J Clin Med
Specialty General Medicine
Date 2024 Jul 13
PMID 38999347
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Abstract

Short-stem prostheses were introduced as an alternative to conventional straight-stem prostheses. Despite their benefits, including minimally invasive approaches, soft-tissue- and bone-sparing implantation, and physiological load transfer to the metaphysis, data on postoperative complication and revision rates as well as on implant survival are scarce. A retrospective analysis of 1327 patients who underwent primary total hip arthroplasty (THA) using the Metha short stem between 2006 and 2023 was conducted. Complication and revision rates were analysed for the intraoperative, direct postoperative, and follow-up episodes. Implant survival was analysed with the endpoint of all-cause stem revision. Intraoperative complications were observed in 3.77% of the cases and included 44 hairline cracks and 6 fractures. In 15 cases (30.0%), conversion to a straight-stem or revision implant was necessary. The direct postoperative complication rate was 2.44%, and 11 revision procedures were performed during inpatient stay (0.84%). Mean follow-up was 7 years (range 1-17). During follow-up, femoral component revision was performed in 60 cases. Aseptic loosening and stem subsidence accounted for a combined percentage of 80% of all indications. Implant survival rate was 95.66% after 5 years, 95.58% after 10 years, and 95.50% after 15 years. Our study provides a comprehensive analysis of postoperative complication and revision rates in a large sample undergoing primary short-stem THA. Postoperative complication rates were favourable, and the long-term implant survival rates were comparable to conventional straight-stem prostheses. Therefore, short-stem THA may be considered an alternative for younger patients.

References
1.
Novikov D, Mercuri J, Schwarzkopf R, Long W, Bosco Iii J, Vigdorchik J . Can some early revision total hip arthroplasties be avoided?. Bone Joint J. 2019; 101-B(6_Supple_B):97-103. DOI: 10.1302/0301-620X.101B6.BJJ-2018-1448.R1. View

2.
Lamb J, Matharu G, Redmond A, Judge A, West R, Pandit H . Risk Factors for Intraoperative Periprosthetic Femoral Fractures During Primary Total Hip Arthroplasty. An Analysis From the National Joint Registry for England and Wales and the Isle of Man. J Arthroplasty. 2019; 34(12):3065-3073.e1. DOI: 10.1016/j.arth.2019.06.062. View

3.
Mittelstaedt H, Anderl C, Ortmaier R, Johl C, Kruger T, Wallroth K . Subsidence analysis of a cementless short stem THA using EBRA-FCA - A seven-year prospective multicentre study. J Orthop. 2023; 43:93-100. PMC: 10415660. DOI: 10.1016/j.jor.2023.06.009. View

4.
Berend K, Lombardi Jr A . Intraoperative femur fracture is associated with stem and instrument design in primary total hip arthroplasty. Clin Orthop Relat Res. 2010; 468(9):2377-81. PMC: 2919873. DOI: 10.1007/s11999-010-1314-8. View

5.
Gwam C, Mistry J, Mohamed N, Thomas M, Bigart K, Mont M . Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty. 2017; 32(7):2088-2092. DOI: 10.1016/j.arth.2017.02.046. View