No differences in clinical and radiographic outcomes between standard offset and high offset short cementless stems

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Arthroplasty research

Background:

• Total hip arthroplasty (THA) is a common procedure for hip joint restoration.
• The choice of femoral stem offset can influence biomechanics and patient outcomes.
• Short cementless stems are increasingly used in THA.

Purpose of the Study:

• To compare clinical and radiographic outcomes of THA using standard offset versus high offset short cementless stems.
• To evaluate the impact of stem offset on patient-reported outcomes and radiographic parameters.

Main Methods:

• A consecutive series of 204 primary THAs using short cementless collared stems was reviewed.
• 190 hips (72 standard offset, 118 high offset) with a minimum 2-year follow-up were analyzed.
• Outcomes included Oxford Hip Score (OHS), Forgotten Joint Score (FJS), and radiographic measures (CFR, CBR, subsidence, misalignment, radiolucent lines, cortical hypertrophy).

Main Results:

• No significant differences in postoperative clinical or radiographic outcomes were observed between standard and high offset stem groups.
• A higher incidence of stems in varus alignment was noted in the high offset group (17% vs 6%).
• Older age, higher BMI, and inflammatory arthropathy were associated with worse OHS; higher BMI correlated with worse FJS.

Conclusions:

• Standard and high offset short cementless stems demonstrate comparable clinical and radiographic outcomes in THA.
• High offset stems are more prone to varus alignment, while cortical hypertrophy is associated with wider canals.
• Patient factors like age, BMI, and inflammatory arthropathy significantly impact functional outcomes.