Interest of short implants in hip arthroplasty for osteonecrosis of the femoral head: comparative study “uncemented short” vs “cemented conventional” femoral stems

Purposes Osteonecrosis of the femoral head (ONFH) is a dramatic condition resulting in joint destruction in the late stages. Total hip arthroplasty allows function recovery with satisfactory implant survival. Recently, the use of uncemented short stems has been suggested to improve the conservation...

Full description

Saved in:
Bibliographic Details
Published in:International orthopaedics 2018-07, Vol.42 (7), p.1669-1674
Main Authors: Miladi, Mehdi, Villain, Benoît, Mebtouche, Nasser, Bégué, Thierry, Aurégan, Jean-Charles
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Original Paper
Orthopedics
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purposes Osteonecrosis of the femoral head (ONFH) is a dramatic condition resulting in joint destruction in the late stages. Total hip arthroplasty allows function recovery with satisfactory implant survival. Recently, the use of uncemented short stems has been suggested to improve the conservation of bone stock. Methods We performed a retrospective study on 16 hip arthroplasties—11 patients—implanted for ONFH between 2008 and 2017. We aimed to compare the outcomes of the two types of arthroplasty—“uncemented short” vs “cemented conventional” femoral stem—in terms of pain (visual analogue scale), function (Harris Hip Score), and survival (radiography). Results We included six  “uncemented short” and ten “cemented conventional” femoral stems. Mean pre-operative EVA was 7.5 and the mean HHS was 40.3. At last follow-up of seven years, mean VAS was 1.2 (SD ± 0.83) in the “uncemented short” group and 1.6 (SD ± 0.97) in the “cemented conventional” group. Mean HHS was 94 (SD ± 0.81) in the “uncemented short” group and 92.6 (SD ± 2.69) in the “cemented conventional” group. However, radiographic analysis revealed a lower stress shielding in the “uncemented short” stem group. One complication occurred (hip dislocation in the “cemented conventional” stem group). Conclusion Uncemented short stems total hip arthroplasties may be an interesting alternative to more conventional implants with similar functional results but less stress shielding and a bone stock economy in this young population of patients.
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-018-3981-0