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Erschienen in: European Journal of Trauma and Emergency Surgery 3/2018

01.06.2018 | Review Article

Long-term follow-up of 1217 consecutive short-stem total hip arthroplasty (THA): a retrospective single-center experience

verfasst von: H. Wacha, G. Domsel, E. Herrmann

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 3/2018

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Abstract

Background

An arthroplasty registry in Germany has been recently established but long-term results for most short-stem innovations are missing. Short-stem hip arthroplasty is usually indicated in young active patients. Our indication was extended to older age groups, femoral neck fractures (FNF), and dysplasia. We evaluated all total hip arthroplasties (THAs) in this population with a collum femoris preserving stem (CFP) performed from 2003 to 2013.

Methods

A consecutive cohort of 1217 CFP THAs with a mean age of 68.7 years was followed retrospectively for a median of 4.8 years (patient follow-up interquartile range from 3.0 to 6.9 years). A questionnaire, which we used in two previous studies, was answered by 89.15% of patients and included information regarding complaints, grade of satisfaction, re-operations, and dislocation. Of the 1217 patients, 77 had died. Survival of the stem and the cup was assessed using a competing risks approach according to an Aalen–Johanson estimator with revision for septic or aseptic loosening or death as a competing endpoint.

Results

Of the patients who answered the questionnaire, 92.5% had no complaints related to the procedures. In all 1217 patients, there were 43 revisions (4.2%) as follows: stem and cup revisions due to aseptic loosening of the stem (n = 10), infections (n = 6), pain (n = 4), or trauma (n = 3); cup revisions due to aseptic loosening (n = 3), dislocation (n = 5), and offset revisions (n = 12). Survivorship was 96% for the stem and 99% for the cup 9 years postoperatively. Statistical analysis confirmed a higher risk for revision in patients with a younger age (p = 0.033), male sex (p = 0.040), dysplasia (p = 0.032), and undersized or extra-large stems for stem revisions (p = 0.001) and female sex (p = 0.036) for cup revisions. FNF (p > 0.20) and age ≥ 80 years (p = 0.114) had no higher risk for loosening of the stem. Our data is also compared with the current literature, especially with the available CFP studies.

Conclusion

The survival rate of the CFP stem was as high as 96% after 9 years of followup which compares well-to-previously published long-term survival rates. There is no higher risk for revision in patients 80 years old or older and in cases with femoral neck fractures. The CFP preserves also allowed using standard stems in the rare cases of revision.
Literatur
1.
Zurück zum Zitat Banerjee S, Pivec R, Issa K, Harwin St F, Mont MA, Khanuja HS. Outcomes of short stems in total hip arthroplasty. Orhtopedics. 2013;36(9):700–7.CrossRef Banerjee S, Pivec R, Issa K, Harwin St F, Mont MA, Khanuja HS. Outcomes of short stems in total hip arthroplasty. Orhtopedics. 2013;36(9):700–7.CrossRef
2.
Zurück zum Zitat Bitzer EM, Grobe TG, Neusser S, Schneider A, Dörning H, Schwartz FW, editor. Barmer GEK Report 2010. Schriftenreihe zur Gesundheitanalyse, Band 3. St.Augustin: Asgard-Verlag; 2010. Bitzer EM, Grobe TG, Neusser S, Schneider A, Dörning H, Schwartz FW, editor. Barmer GEK Report 2010. Schriftenreihe zur Gesundheitanalyse, Band 3. St.Augustin: Asgard-Verlag; 2010.
3.
Zurück zum Zitat BQS (2009). Hüftprothesen-Erstimplantation. BQS-Leistungsbereiche mit Dokumentationspflicht. Outcome, BQS Bundesgeschäftsstelle Qualitätssicherung gGmbH 2009: 2008-D7514-L58612-P26095. BQS (2009). Hüftprothesen-Erstimplantation. BQS-Leistungsbereiche mit Dokumentationspflicht. Outcome, BQS Bundesgeschäftsstelle Qualitätssicherung gGmbH 2009: 2008-D7514-L58612-P26095.
4.
Zurück zum Zitat Hailer N, Garellick G, Kärrholm J. Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register. Acta Orthop. 2010;81(1):34–41.CrossRefPubMedPubMedCentral Hailer N, Garellick G, Kärrholm J. Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register. Acta Orthop. 2010;81(1):34–41.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Zwartelé R, Witjes S, Doets HC, Stijnen T, Pöll RG. (2012). Cementless total hip arthroplasty in rheumatoid arthritis: a systematic review of the literature. Arch Orthop Trauma Surg 132(4): 535–46.CrossRef Zwartelé R, Witjes S, Doets HC, Stijnen T, Pöll RG. (2012). Cementless total hip arthroplasty in rheumatoid arthritis: a systematic review of the literature. Arch Orthop Trauma Surg 132(4): 535–46.CrossRef
6.
Zurück zum Zitat Van Oldenrijk J, Molleman J, Klaver M, Poolman RW, Haverkamp D. Revision rate after short-stem total hip arthroplasty: a systematic review of 49 studies. Acta Orthop. 2014;85.(3):250–8.CrossRefPubMedPubMedCentral Van Oldenrijk J, Molleman J, Klaver M, Poolman RW, Haverkamp D. Revision rate after short-stem total hip arthroplasty: a systematic review of 49 studies. Acta Orthop. 2014;85.(3):250–8.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Pipino F. A. w. D. o. O. a. T., Policlinico of Monza (2004). CFP prosthetic stem in mini-invasive total hip arthroplasty. J Orthop Traumatol 5 (3): 165–71).CrossRef Pipino F. A. w. D. o. O. a. T., Policlinico of Monza (2004). CFP prosthetic stem in mini-invasive total hip arthroplasty. J Orthop Traumatol 5 (3): 165–71).CrossRef
8.
Zurück zum Zitat Pipino F, Grandizio M Molfetta M. Preservation of the fermoral neck in hip arthroplasty: results of a 13-to 17-year follow-up J Orthop Traumatol. 2000;1(1):31–9.CrossRef Pipino F, Grandizio M Molfetta M. Preservation of the fermoral neck in hip arthroplasty: results of a 13-to 17-year follow-up J Orthop Traumatol. 2000;1(1):31–9.CrossRef
9.
Zurück zum Zitat Wacha H, Domsel G, Mootz R. Collum femoris retaining hip system-3 years follow-up. Orthopädische Praxis. 2007;43(8):436–44. Wacha H, Domsel G, Mootz R. Collum femoris retaining hip system-3 years follow-up. Orthopädische Praxis. 2007;43(8):436–44.
10.
Zurück zum Zitat Wacha H, Domsel G, Gawad KA. (2009). C.F.P.-Kurzschaftprothese- 5 Jahres-Ergebnisse. 58 th Jahrestagung Nord-West-Deutscher Orthopäden-Hamburg :V 22.7. Wacha H, Domsel G, Gawad KA. (2009). C.F.P.-Kurzschaftprothese- 5 Jahres-Ergebnisse. 58 th Jahrestagung Nord-West-Deutscher Orthopäden-Hamburg :V 22.7.
11.
Zurück zum Zitat Jerosch J. (2013). Kurzschaft-endoprothesen, Wo liegen die Unterschiede? Köln, Deutscher Ärzte-Verlag. Jerosch J. (2013). Kurzschaft-endoprothesen, Wo liegen die Unterschiede? Köln, Deutscher Ärzte-Verlag.
12.
Zurück zum Zitat Röhrl S, Li MG, Pedersen E, Ullmark G, Nivbrant B. (2006). Migration pattern of a short femoral neck preserving stem. Clin Orthop Retated Res 488: 73–8.CrossRef Röhrl S, Li MG, Pedersen E, Ullmark G, Nivbrant B. (2006). Migration pattern of a short femoral neck preserving stem. Clin Orthop Retated Res 488: 73–8.CrossRef
13.
Zurück zum Zitat Noureddine B, D¨orner C, Scheunemann D, Wurm M, Schulz AP. (2007). Early results of the CFP prosthesis in post-traumatic hip deformity.” j.injury.2007. 11.307. Noureddine B, D¨orner C, Scheunemann D, Wurm M, Schulz AP. (2007). Early results of the CFP prosthesis in post-traumatic hip deformity.” j.injury.2007. 11.307.
14.
Zurück zum Zitat Gill I, Gill K, Jayasekera N, Miller J. Medium term results of the collum femoris preserving hydroxyapatite coated total hip replacement. Hip International. 2008;18(2):75–80.CrossRefPubMed Gill I, Gill K, Jayasekera N, Miller J. Medium term results of the collum femoris preserving hydroxyapatite coated total hip replacement. Hip International. 2008;18(2):75–80.CrossRefPubMed
15.
Zurück zum Zitat Pons M. Learning curve and short-term results with a short-stem CFP system. Hip Int Suppl. 2010;7(S5):2–7. Pons M. Learning curve and short-term results with a short-stem CFP system. Hip Int Suppl. 2010;7(S5):2–7.
16.
Zurück zum Zitat Nowak M, Nowak TE, Schmidt R, Forst R, Kress AM, Mueller LA. (2011). “Prospective study of a cementless total hip arthroplasty with a collum femoris preserving stem and a trabeculae oriented pressfit cup: minimum 6-year follow-up.”. Acta Orthop Trauma Surg. 131(4): 549 – 55. Nowak M, Nowak TE, Schmidt R, Forst R, Kress AM, Mueller LA. (2011). “Prospective study of a cementless total hip arthroplasty with a collum femoris preserving stem and a trabeculae oriented pressfit cup: minimum 6-year follow-up.”. Acta Orthop Trauma Surg. 131(4): 549 – 55.
17.
Zurück zum Zitat Briem D, Schneider M, Bogner N, Botha N, Gebauer M, Gehrke T, Schwantes B Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop. 2011 35(5):655–60.CrossRefPubMed Briem D, Schneider M, Bogner N, Botha N, Gebauer M, Gehrke T, Schwantes B Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop. 2011 35(5):655–60.CrossRefPubMed
18.
Zurück zum Zitat RIPO (2013). Annual Report 2000–2011. Emilia-Romagna (RIPO. S. Report, Institut für Ergebnisforschung in der Orthopädie: 72. RIPO (2013). Annual Report 2000–2011. Emilia-Romagna (RIPO. S. Report, Institut für Ergebnisforschung in der Orthopädie: 72.
19.
Zurück zum Zitat Wang Y, Liu M, Li JW, Hao YJ, Li JF, Yang J, Li GH. Application of CFP short-stem prosthesis in the treatment of osteonecrosis of the femoral head. Zhonghua Yi Xue Za Zhi. 2011;91(47):3320–3.PubMed Wang Y, Liu M, Li JW, Hao YJ, Li JF, Yang J, Li GH. Application of CFP short-stem prosthesis in the treatment of osteonecrosis of the femoral head. Zhonghua Yi Xue Za Zhi. 2011;91(47):3320–3.PubMed
20.
Zurück zum Zitat Kress A, Schmidt R, Nowak TE, Nowak M, Haeberle L, Forst R, Mueller LA. Stress-related femoral cortical and cancellous bone density loss after collum femoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography. Arch Orthop Trauma Surg. 2012;132(8):1111–9.CrossRefPubMed Kress A, Schmidt R, Nowak TE, Nowak M, Haeberle L, Forst R, Mueller LA. Stress-related femoral cortical and cancellous bone density loss after collum femoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography. Arch Orthop Trauma Surg. 2012;132(8):1111–9.CrossRefPubMed
21.
Zurück zum Zitat Li M, Li HY, Liao K, Wen Q, Zhong T D. Mid-term effectiveness of total hip arthroplasty with collum femoris preserving prosthesis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26(8):897–901.PubMed Li M, Li HY, Liao K, Wen Q, Zhong T D. Mid-term effectiveness of total hip arthroplasty with collum femoris preserving prosthesis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26(8):897–901.PubMed
22.
Zurück zum Zitat Ghera S, Bisicchia S. The collum femoris preserving stem: early results. Hip Int. 2013;23(1):27–32.CrossRefPubMed Ghera S, Bisicchia S. The collum femoris preserving stem: early results. Hip Int. 2013;23(1):27–32.CrossRefPubMed
23.
Zurück zum Zitat Hutt J, Harb Z, Gill I, Kashif F, Miller J, Dodd M. (2014). Ten year results of the collum femoris preserving total hip replacement: a prospective cohort study of seventy five patients. Int Orthop 38(5): 917 – 22. Hutt J, Harb Z, Gill I, Kashif F, Miller J, Dodd M. (2014). Ten year results of the collum femoris preserving total hip replacement: a prospective cohort study of seventy five patients. Int Orthop 38(5): 917 – 22.
24.
Zurück zum Zitat Kendoff D, Citak M, Egidy CC, O’Loughlin PF, Gehrke T. Eleven-year results of the anatomic coated CFP stem in primary total hip arthroplasty. J Arthroplast. 2013;28(6):1047–51.CrossRef Kendoff D, Citak M, Egidy CC, O’Loughlin PF, Gehrke T. Eleven-year results of the anatomic coated CFP stem in primary total hip arthroplasty. J Arthroplast. 2013;28(6):1047–51.CrossRef
25.
Zurück zum Zitat Lazarinis S, Mattsson P, Milbrink J, Mallmin H, Hailer NP. (2013). A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA. Primary stability but no prevention of proximal bone loss in 27 patients followed for 2 years. Acta Orthop 84(1): 32–9CrossRef Lazarinis S, Mattsson P, Milbrink J, Mallmin H, Hailer NP. (2013). A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA. Primary stability but no prevention of proximal bone loss in 27 patients followed for 2 years. Acta Orthop 84(1): 32–9CrossRef
26.
Zurück zum Zitat Domsel G, Th F, Hristova Y, Gawad KA. (2011) Zementfreie Kurzschaftprothese bei alten Patienten Unfallchirurg. 114 (Supplement 2):92. (Abstracts Nr.62.08.) Domsel G, Th F, Hristova Y, Gawad KA. (2011) Zementfreie Kurzschaftprothese bei alten Patienten Unfallchirurg. 114 (Supplement 2):92. (Abstracts Nr.62.08.)
27.
Zurück zum Zitat Mäkelä K, Matilainen M, Pulkkinen P, Fenstad AM, Havelin L, Engesaeter L, Furnes O, Pedersen AB, Overgaard S, Kärrholm J, Malchau H, Garellick G, Ranstam J, Eskelinen A. (2014). Failure rate of cemented and uncemented total hip replacements: register study of combined Nordic database of four nations. BMJ 13(348): f7592.CrossRef Mäkelä K, Matilainen M, Pulkkinen P, Fenstad AM, Havelin L, Engesaeter L, Furnes O, Pedersen AB, Overgaard S, Kärrholm J, Malchau H, Garellick G, Ranstam J, Eskelinen A. (2014). Failure rate of cemented and uncemented total hip replacements: register study of combined Nordic database of four nations. BMJ 13(348): f7592.CrossRef
28.
Zurück zum Zitat Pedersen A, Mehnert F, Havelin LI, Furnes O, Herberts P, Kärrholm J, Garellick G, Mäkela K, Eskelinen A, Overgaard S. Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association Osteoarthr Cartil. 2014;22(5):659–67.CrossRefPubMed Pedersen A, Mehnert F, Havelin LI, Furnes O, Herberts P, Kärrholm J, Garellick G, Mäkela K, Eskelinen A, Overgaard S. Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association Osteoarthr Cartil. 2014;22(5):659–67.CrossRefPubMed
30.
Zurück zum Zitat Rometsch E, Bos PK, Koes BW. (2012). Survival of short hip stems with a “modern”, trochanter-sparing design—a systematic literature review. Hip Int. 22(4): 344–54.CrossRef Rometsch E, Bos PK, Koes BW. (2012). Survival of short hip stems with a “modern”, trochanter-sparing design—a systematic literature review. Hip Int. 22(4): 344–54.CrossRef
31.
Zurück zum Zitat Van Oldenrijk J, Schafroth MU, Rijk E, Runne WC, Verheyen CC, van Egmond C, Bhandari M, Poolman RW. Learning curve analysis of the Collum Femoris Preserving total hip surgical technique. Hip Int. 2013;23(2):154–61.CrossRefPubMed Van Oldenrijk J, Schafroth MU, Rijk E, Runne WC, Verheyen CC, van Egmond C, Bhandari M, Poolman RW. Learning curve analysis of the Collum Femoris Preserving total hip surgical technique. Hip Int. 2013;23(2):154–61.CrossRefPubMed
32.
Zurück zum Zitat Aldinger P, Sabo D, Pritsch M, Thomsen M, Mau H, Ewerbeck V, Breusch SJ Pattern of periprosthetic bone remodeling around stable uncemented tapered hip stems: a prospective 84-month follow-up study and a median 156-month cross-sectional study with DXA. Calcif Tissue Int. 2003;73(2):115–21.CrossRefPubMed Aldinger P, Sabo D, Pritsch M, Thomsen M, Mau H, Ewerbeck V, Breusch SJ Pattern of periprosthetic bone remodeling around stable uncemented tapered hip stems: a prospective 84-month follow-up study and a median 156-month cross-sectional study with DXA. Calcif Tissue Int. 2003;73(2):115–21.CrossRefPubMed
33.
Zurück zum Zitat Albanese C, Santori FS, Pavan L, Learmonth ID, Passariello R. Periprosthetic DXA after total hip arthroplasty with short vs. ultra-short custom-made femoral stems: 37 patients followed for 3 years. Acta Orthop. 2009;80(3):291–7.CrossRefPubMedPubMedCentral Albanese C, Santori FS, Pavan L, Learmonth ID, Passariello R. Periprosthetic DXA after total hip arthroplasty with short vs. ultra-short custom-made femoral stems: 37 patients followed for 3 years. Acta Orthop. 2009;80(3):291–7.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Götze C, Ehrenbrink J, Ehrenbrink H. Is there a bone-preserving bone remodelling in short-stem prosthesis? DEXA analysis with the Nanos total hip arthroplasty. Z Orthop Unfall. 2010;148(4):398–405.CrossRefPubMed Götze C, Ehrenbrink J, Ehrenbrink H. Is there a bone-preserving bone remodelling in short-stem prosthesis? DEXA analysis with the Nanos total hip arthroplasty. Z Orthop Unfall. 2010;148(4):398–405.CrossRefPubMed
35.
Zurück zum Zitat Chen H, Morrey BF, An KN, Luo ZP. Bone remodeling characteristics of a short-stemmed total hip replacement. J Arthroplasty. 2009;24(6):945–50.CrossRefPubMed Chen H, Morrey BF, An KN, Luo ZP. Bone remodeling characteristics of a short-stemmed total hip replacement. J Arthroplasty. 2009;24(6):945–50.CrossRefPubMed
36.
Zurück zum Zitat Schmidt R, Gollwitzer S, Nowak TE, Nowak M, Kress A, Forst R, Müller LA. (2011). Periprosthetic femoral bone reaction after total hip arthroplasty with preservation of the collum femoris: CT-assisted osteodensitometry 1 and 3 years postoperatively. Orthopäde. 40: 591–9.CrossRefPubMed Schmidt R, Gollwitzer S, Nowak TE, Nowak M, Kress A, Forst R, Müller LA. (2011). Periprosthetic femoral bone reaction after total hip arthroplasty with preservation of the collum femoris: CT-assisted osteodensitometry 1 and 3 years postoperatively. Orthopäde. 40: 591–9.CrossRefPubMed
37.
Zurück zum Zitat Rudman K, Aspden RM, Meakin JR. Compression or tension? The stress distribution in the proximal femur. Biomed Eng Online. 2006;20(5):12.CrossRef Rudman K, Aspden RM, Meakin JR. Compression or tension? The stress distribution in the proximal femur. Biomed Eng Online. 2006;20(5):12.CrossRef
38.
Zurück zum Zitat Biggi F, Franchin F, Lovato R, Pipino F. DEXA evaluation of total hip arthroplasty with neck-preserving technique: 4 year follow-up. J Orthop Traumatol. 2004;5(3):156–9.CrossRef Biggi F, Franchin F, Lovato R, Pipino F. DEXA evaluation of total hip arthroplasty with neck-preserving technique: 4 year follow-up. J Orthop Traumatol. 2004;5(3):156–9.CrossRef
39.
Zurück zum Zitat Howie D, Holubowycz OT, Middleton R. Large Articulation Study Group. (2012). Large femoral heads decrease the incidence of dislocation after total hip arthroplasty: a randomized controlled trial. J Bone Joint Surg Am. 94(12): 1095–102. Howie D, Holubowycz OT, Middleton R. Large Articulation Study Group. (2012). Large femoral heads decrease the incidence of dislocation after total hip arthroplasty: a randomized controlled trial. J Bone Joint Surg Am. 94(12): 1095–102.
40.
Zurück zum Zitat Sexton S, Walter WL, Jackson MP, De Steiger R, Stanford T. Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement. J Bone Joint Surg BR. 2009;91(11):1448–53.CrossRefPubMed Sexton S, Walter WL, Jackson MP, De Steiger R, Stanford T. Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement. J Bone Joint Surg BR. 2009;91(11):1448–53.CrossRefPubMed
Metadaten
Titel
Long-term follow-up of 1217 consecutive short-stem total hip arthroplasty (THA): a retrospective single-center experience
verfasst von
H. Wacha
G. Domsel
E. Herrmann
Publikationsdatum
01.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 3/2018
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-017-0895-2

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