Ultra-Short Versus Conventional Uncemented Stems for Hip Replacement in Octogenarians

Area of Science:

• Orthopedics
• Biomedical Engineering

Background:

• Total hip arthroplasty (THA) is a common procedure for hip joint diseases.
• Octogenarians represent a growing demographic undergoing THA, requiring careful consideration of implant choice.
• Uncemented femoral stems are widely used, with variations in design impacting outcomes.

Purpose of the Study:

• To compare the survival rates of ultra-short anatomic uncemented stems versus conventional diaphyseal filling uncemented stems in primary THA for octogenarians.
• To evaluate complications such as thigh pain and periprosthetic fractures associated with each stem type.

Main Methods:

• A comparative study involving 52 patients (55 hips) with ultra-short stems and 61 patients (72 hips) with conventional stems.
• Patients were predominantly diagnosed with osteoarthritis or osteonecrosis of the femoral head.
• Follow-up averaged 6.1 years for the ultra-short stem group and 6.3 years for the conventional stem group.

Main Results:

• No significant difference in pre- or postoperative Harris hip scores between the groups.
• Ultra-short stems had 0% incidence of thigh pain, compared to 15% in the conventional stem group.
• Similar revision rates (1.8% vs 1.4%) and stem survivorship (98.2% vs 98.6%) were observed.

Conclusions:

• Both ultra-short anatomic and conventional diaphyseal filling uncemented stems achieved osseointegration in all hips.
• Ultra-short stems were associated with a significantly lower prevalence of thigh pain and periprosthetic fractures.
• Ultra-short stems may be a favorable option for primary THA in octogenarians due to reduced complications.