Anzeige
Erschienen in:
01.02.2012 | Symposium: Papers Presented at the Annual Meetings of The Hip Society
Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older
Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 2/2012
Einloggen, um Zugang zu erhaltenAbstract
Background
Limitations of conventional uncemented femoral stems persist, including proximal-distal mismatch, nonideal load transfer, loss of bone, and difficulties with minimally invasive surgery. Metaphyseal-engaging short-stem implants have been designed to address these issues in THA. While these devices have been studied in younger patients, it is unclear whether they offer advantages in older patients.
Questions/purposes
We asked whether the stability and bony ingrowth of an off-the-shelf short stem in patients 70 years and older were similar to those achieved in patients younger than 70 years at 2-year followup. Furthermore, we asked whether pain and function scores were affected by age, bone quality, or varus alignment.
Patients and Methods
We retrospectively reviewed 60 patients (65 hips) 70 years and older (mean, 75 years; range, 70–86 years) treated with an uncemented short stem (range, 90–105 mm). We compared radiographic alignment, stability, and bony ingrowth, as well as Harris hip scores and WOMAC pain scores, to a cohort of 89 patients (91 hips) younger than 70 years. Minimum followup was 24 months (mean, 35 months; range, 24–60 months).
Results
Radiographs showed proximal bony ingrowth and stable fixation of all implants. Average Harris hip score at last followup was 88 (range, 70–100) for the 70 years and older cohort and 93 (range, 70–100) for younger than 70 years cohort; no patients reported thigh pain. Postoperative WOMAC scores averaged 6 (range, 0–43) and 5 (range, 0–25), respectively.
Conclusions
Short-stem implants provide solid, dependable fixation in osteoporotic bone at minimum 2-year followup, while meeting some of the limitations in conventional primary THA.
Level of Evidence
Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.