Abstract
Introduction
Cementless stems have been used in treatment of patients with osteoarthritis however, the new design concept of neck preserving stems also known as short femoral stems have been utilized to decrease the potentially adverse symptoms of the standard stems such as stress shielding and thigh pain. In this ongoing study we aim to demonstrate the clinical and radiographic outcome of direct anterior approach of total hip arthroplasty (THA) by using short stem prosthesis.
Methods
In this study, 390 total cases of THA in 345 patients who underwent an anterior approach of THA by using a short-stem prosthesis (Minihip, Corin) between 2009 and 2013 were reviewed.
This group included 282 male and 62 female patients. Table 1 summarizes the demographic information of the patients. In 48 cases avascular necrosis (AVN) was the diagnosis and 339 cases was reported to be due to osteoarthritis. Twenty eight patients were assessed to have American Society of Anesthesiologist (ASA) physical functional score of class I, 258 patients had class II, 103 had class III, and 1 had class IV. Table 2 shows the Charnley classification of the patients.
In the current study we evaluated the outcomes of the surgery by utilizing Hip Disability and Osteoarthritis Outcome Score (HOOS) subscales (Pain, Symptoms, Function in daily living (ADL), Function in sport and recreation (Sport/Rec) and Quality of life (QOL)).
Results
All HOOS subscores were significantly increased postoperatively (F (5,97) = 1679, p < 0.001). The outcome are summarized in Table 4 and Figure 1. No failure of the implant has yet been reported however in 9 cases (2%) calcar fracture occurred during the surgery that was successfully treated with cerclage wires.
Conclusion and Discussion
This study continues to support the excellent clinical outcomes of this short-stem prosthesis when is used for primary total hip arthroplasty. This short stem implant is an excellent choice particularly for younger individuals by preserving femoral neck bone that may provide easier revision procedures in the future.
