Fourteen-year experience with short cemented stems in total hip replacement

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering

Background:

• Increasing age of patients needing total hip replacement (THR) may necessitate the use of cemented femoral stems.
• Short cemented femoral devices offer advantages like metaphyseal bone preservation, easier insertion, and simplified cement removal during revision surgery.

Purpose of the Study:

• To describe the rationale behind using a unique short cemented double-tapered polished stem.
• To assess the midterm clinical and radiographic outcomes of this innovative stem design.

Main Methods:

• Two groups of elderly patients received either a prototype (Group 1, n=43) or final commercial version (Group 2, n=54) of the short cemented stem.
• Patients underwent clinical evaluation using the Harris Hip Score (HHS) and radiographic assessment.
• Follow-up durations were 11.2 years for surviving Group 1 patients and 4.6 years for surviving Group 2 patients.

Main Results:

• Harris Hip Score improved in both groups.
• A Grade A cement mantle was observed in 34/43 hips (Group 1) and 41/54 hips (Group 2).
• Survival rate with revision for aseptic loosening as the endpoint was 100% in both groups.

Conclusions:

• The short, polished, collarless, tapered cemented stem is effective when implanted using contemporary cementing techniques.
• This stem design demonstrates outcomes comparable to standard-sized cemented components.
• The study supports the use of this short cemented stem in the elderly population requiring total hip replacement.