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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Technical considerations and functional results in primary uncemented hip arthroplasty using short femoral stems
1Orthopedics - Traumathology Clinic, "Dr. Carol Davila" Central Military University Emergency Hospital, Bucharest, Romania.
Abstract:
Primary hip arthroplasty is a surgical procedure through which the coxofemoral joint is replaced with a prosthetic implant. Arthroplasties can be total or partial, cemented or uncemented. These procedures are generally indicated as a form of treatment for arthritic pain or in the case of severe trauma, such as femoral neck fractures. The most commonly used approaches are: Smith Peterson, Watson Jones, Hardinge, Moore Southern and Ludloff. Recently, mini-invasive approaches have started being used, while correlated with short femoral stems. Short metaphyseal femoral stems have been introduced as an alternative to conventional stems, having a series of advantages: preservation of bone stock (high cervical osteotomies), preservation of the anatomical anteversion of the femural neck, decrease in cortical stress forces, decrease in the remaining thigh pain, a longer life of the prosthesis, with the possibility of revision to a conventional prosthesis, and the possibility to be used in correlation with mini-invasive procedures. Short femoral stems implanted through a mini-invasive approach allow the conservation of the femoral bone stock, permitting an ulterior re-intervention, in the context of an ageing population, with a globally rising long-term survival rate. Moreover, the superiority of the total hip arthroplasty with a short femoral stem was discussed through mini-invasive approaches, in the day-to-day realities of our Clinic.
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