Low Short-Stem Revision Rates: 1-11 Year Results From 1888 Total Hip Arthroplasties

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering

Background:

• Short stems in total hip arthroplasty (THA) were designed as a bone-preserving alternative to conventional cementless stems.
• Limited medium to long-term outcome data exist for these newer implants.

Purpose of the Study:

• To evaluate the midterm survival and clinical outcomes of calcar-loading short stems in THA.
• To compare the performance of different versions of short stems.

Main Methods:

• Retrospective analysis of 1888 Metha stem implantations between 2004 and 2014.
• Categorization into three groups: monoblock, modular titanium neck, and modular cobalt-chrome neck stems.
• Postoperative patient questionnaires regarding revision, dislocation, and satisfaction; data analyzed for 1090 monoblock, 314 modular titanium, and 230 modular cobalt-chrome stems.

Main Results:

• Mean follow-up was 6 years (range 1-11 years).
• Cone fractures occurred in 4% (15/314) of modular titanium stems.
• Seven-year revision rates were 1.5% for monoblock, 1.8% for modular cobalt-chrome, and 5.3% for modular titanium stems.

Conclusions:

• Monoblock and modular cobalt-chrome short stems demonstrate midterm survival rates comparable to traditional cementless stems.
• These short stem designs may serve as a viable bone-conserving option for younger, active patients undergoing total hip arthroplasty.