Total hip replacement with a short cementless stem type 2B: Results of 2 to 5 years of follow-up
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Published:
May 2, 2019
Keywords:
total hip arthroplasty, cementless short stem, hip osteoarthritis.
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Abstract
Objectives: We sought to determine our 2 to 5-year survivorship, intraoperative fractures, subsidence and thigh pain rate in a consecutive, independent, one surgeon series of patients in whom a type-2B short stem was implanted.Patients and Methods: The first 100 type 2B consecutive short femoral stems implanted in 84 patients with a mean age of 47 years old were reviewed. Indications included age younger than 55 years (85 hips), or participation in impact sports in patients aging 56 to 60 years old (15 hips). Initial diagnosis was osteoarthritis in 82% of the cases. Median follow-up was 42 months.Results: Stem survival rate was 99% at 2 to 5 years for stem revision for any aseptic reason and 98% when infection was included. The mean Harris Hip Score improved significantly from 55 to 96 at final follow-up (p 0.02). There was one lateral cortex perforation, and three intraoperative calcar incomplete fractures (3%), only one of them required cerclage wiring and delayed weightbearing. No patient referred thigh pain at final follow-up. Only one case subsided 4 mm and then stabilized. The risk of revision was 1% at 2 to-5 years (95%CI 93.1-99.8%).Conclusions: Promising short-term results with this design were observed in this single surgeon, non-designerconsecutive series including the learning curve period using a type 2B short stem in young active patients, in which bone preservation is justified.
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Buttaro, M., Nally, F., Salcedo, R., Slullitel, P. A., Oñativia, J. I., Comba, F., & Piccaluga, F. (2019). Total hip replacement with a short cementless stem type 2B: Results of 2 to 5 years of follow-up. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 84(2), 112-121. https://doi.org/10.15417/issn.1852-7434.2019.84.2.856
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Clinical Research
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References
1. Pipino F, Molfetta L. Femoral neck preservation in total hip replacement. Ital J OrthopTraumatol 1993;19:5-12.
2. Khanuja HS, Banerjee S, Jain D, Pivec R, Mont MA. Short bone conserving stems in cementless hip arthroplasty. J Bone Joint Surg Am 2014;96(20):1742-52. https://doi.org/10.2106/JBJS.M.00780
3. Teoh KH, Lee PY, Woodnutt DJ. Our early experience of the Corin Minihip prosthesis. Hip Int 2016;16;26(3): 265-9. https://doi.org/10.5301/hipint.5000343
4. Ender SA, Machner A, Pap G, Hubbe J, Grashoff H, Neumann HW. Cementless CUT femoral neck prosthesis: increased rate of aseptic loosening after 5 years. Acta Orthop 2007;78(5):616-21. https://doi.org/10.1080/17453670710014301
5. Ender SA, Machner A, Pap G, Grasshoff H, Neumann HW. The femoral neck prosthesis CUT. Three- to six-year results. Orthopade 2006;35(8):841-7. https://doi.org/10.1007/s00132-006-0986-y
6. Ender SA, Machner A, Hubbe J, Pap G, Neumann HW. Medium-term results of the cementless femoral neck prosthesis CUT. Z Orthop Ihre Grenzgeb 2006;144(5):477-83. https://doi.org/10.1055/s-2006-942265
7. Ng VY, Arnott L, McShane MA. Perspectives in managing an implant recall: revision of 94 Durom Metasul acetabular components. J Bone Joint Surg Am 2011;93:e100(1-5). https://doi.org/10.2106/JBJS.J.01311
8. Rudert M, Leichtle U, Leichtle C, Thomas W. Implantation technique for the CUT-type femoral neck endoprosthesis. Oper Orthop Traumatol 2007;19(5-6):458-72. https://doi.org/10.1007/s00064-007-1018-4
9. Steens W, Skripitz R, Schneeberger AG, Petzing I, Simon U, Goetze C. Cementless femoral neck prosthesis CUT—clinical and radiological results after 5 years. Z Orthop Unfall 2010;148(4):413-9. https://doi.org/10.1055/s-0030-1250150
10. Thomas W, Lucente L, Mantegna N, Grundei H. ESKA (CUT) endoprosthesis. Orthopade 2004;33(11):1243-8. https://doi.org/10.1007/s00132-004-0717-1
11. Kendoff DO, Citak M, Egidy CC, O’Loughlin PF, Gehrke T. Eleven-year results of the anatomic coated CFP stem in primary total hip arthroplasty. J Arthroplasty 2013;28(6):1047-51. https://doi.org/10.1016/j.arth.2012.10.013
12. Briem D, Schneider M, Bogner N, Botha N, Gebauer M, Gehrke T, et al. Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop 2011;35(5):655-60. https://doi.org/10.1007/s00264-010-1020-x
13. Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, Rorabeck CH. Soft-tissue balancing of the hip: the role of femoral offset restoration. Instr Course Lect 2005;54:131-41.
14. Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979;141:17-27. https://doi.org/10.1097/00003086-197906000-00002
15. Ghera S, Bisicchia S. The collum femoris preserving stem: early results. Hip Int 2013;23(1):27-32. https://doi.org/10.5301/HIP.2013.10718
16. Gill IR, Gill K, Jayasekera N, Miller J. Medium term results of the collum femoris preserving hydroxyapatite coated total hip replacement. Hip Int 2008;18(2):75-80. https://doi.org/10.1177/112070000801800202
17. Kress AM, Schmidt R, Nowak TE, Nowak M, Haeberle L, Forst R, et al. Stress-related femoral cortical and cancellous bone density loss after collumfemoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography. Arch Orthop Trauma Surg 2012;132(8):1111-9. https://doi.org/10.1007/s00402-012-1537-0
18. Molfetta L, Capozzi M, Caldo D. Medium term follow up of the Biodynamic neck sparing prosthesis. Hip Int 2011;21(1):76-80. https://doi.org/10.5301/hip.2011.6296
19. Nowak M, Nowak TE, Schmidt R, Forst R, Kress AM, Mueller LA. Prospective study of a cementless total hip arthroplasty with a collumfemoris preserving stem and a trabeculae oriented pressfit cup: minimun 6-year followup. Arch Orthop Trauma Surg 2011;131(4):549-55. https://doi.org/10.1007/s00402-010-1189-x
20. Pipino F, Molfetta L, Grandizio M. Preservation of the femoral neck in hip arthroplasty: results of a 13-17-year follow-up. J Orthop Traumatol 2000;1:31-9. https://doi.org/10.1007/s101950070026
21. Pipino F. CFP prosthetic stem in mini-invasive total hip arthroplasty. J Orthop Traumatol 2004;4(3):165-71.
https://doi.org/10.1007/s10195-004-0065-2
22. Rohrl SM, Li MG, Pedersen E, Ullmark G, Nivbrant B. Migration pattern of a short femoral neck preserving stem. Clin Orthop Relat Res 2006;448(448):73-8. https://doi.org/10.1097/01.blo.0000224000.87517.4c
23. Nieuwenhuijse MJ, Valstar ER, Nelissen RG. 5-year clinical and radiostereometric analysis (RSA) follow-up of 39 CUT femoral neck total hip prostheses in young osteoarthritis patients. Acta Orthop 2012;83(4):334-41. https://doi.org/10.3109/17453674.2012.702392
24. Pons M. Learning curve and short-term results with a short-stem CFP system. Hip Int 2010;20(Suppl 7):S52-7. https://doi.org/10.5301/HIP.2010.4443
25. Jerosch J, Grasselli C, Kothny PC, Litzkow D, Hennecke T. Reproduction of the anatomy (offset, CCD, leg length) with a modern short stem hip design—a radiological study. Z Orthop Unfall 2012;150(1):20-6. https://doi.org/10.1055/s-0030-1270965
26. Lindgren JU, Rysavy J. Restoration of femoral offset during hip replacement: a radiographic cadaver study. Acta Orthop Scand 1992;63:407-10. https://doi.org/10.3109/17453679209154755
27. González Della Valle A, Slullitel G, Piccaluga F, Salvati EA. The precision and usefulness of preoperative planning for cemented and hybrid primary total hip arthroplasty. J Arthroplasty 2005;20(1):51-8. https://doi.org/10.1016/j.arth.2004.04.016
28. Salvati EA, Sharrock NE, Westrich G, Potter HG, Valle AG, Sculco TP. The 2007 ABJS Nicolas Andry Award: three decades of clinical, basic, and applied research on thromboembolic disease after THA: rationale and clinical results of a multimodal prophylaxis protocol. Clin Orthop Relat Res 2007;(459):246-54. https://doi.org/10.1097/BLO.0b013e31805b7681
29. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737-55.
https://doi.org/10.2106/00004623-196951040-00012
30. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 1990;257:107-28.
https://doi.org/10.1097/00003086-199008000-00022
31. Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457-81. https://doi.org/10.1080/01621459.1958.10501452
32. 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. https://doi.org/10.3109/17453674.2014.908343
33. Hodge WA, Andriacchi TP, Galante JO. A relationship between stem orientation and function following total hip arthroplasty. J Arthroplasty 1991;6:229-35. https://doi.org/10.1016/s0883-5403(06)80169-5
34. Konyves A, Bannister GC. The importance of leg length discrepancy after total hip arthroplasty. J Bone Joint Surg Br 2005;87:155-7. https://doi.org/10.1302/0301-620X.87B2.14878
35. Steinberg B, Harris WH. The offset problem in total hip arthroplasty. Contemp Orthop 1992;24:556-62.
36. Nally FJ, Rossi LA, Diaz F, Stagnaro J, Slullitel PAI, Buttaro MA. Which prosthetic system restores hip biomechanics more effectively? Comparison among three systems. Curr Orthop Prac 2015;(26)4:382-6. https://doi.org/10.1097/BCO.0000000000000242
37. Wedemeyer C, Quitmann H, Xu J, Heep H, von Knoch M, Saxler G. Digital templating in total hip arthroplasty with the Mayo stem. Arch Orthop Trauma Surg 2008;128(10):1023-9. https://doi.org/10.1007/s00402-007-0494-5
38. Kim YH, Park JW, Kim JS. Ultrashort versus conventional anatomic cementless femoral stems in the same patients younger than 55 years. Clin Orthop Relat Res 2016;474(9):2008-17. https://doi.org/10.1007/s11999-016-4902-4
39. Wright JG, Einhorn TA, Heckman JD. Grades of recommendation. J Bone Joint Surg Am 2005;87(9):1909-10. https://doi.org/10.2106/JBJS.8709.edit
40. Vidalain JP. Twenty-year results of the cementless Corail stem. Int Orthop 2011;35:189-94. https://doi.org/10.1007/s00264-010-1117-2
41. Buttaro M, Martorell G, Quinteros M, Comba F, Zanotti G, Piccaluga F. Preservación ósea femoral con tallos cortos de fijación cervicometafisaria. Estudio radiográfico comparativo con tallos no cementados de fijación metafisaria. Rev Asoc Argent Ortop Traumatol 2015;79(4):232-6. http://www.scielo.org.ar/pdf/raaot/v79n4/v79n4a06.pdf
2. Khanuja HS, Banerjee S, Jain D, Pivec R, Mont MA. Short bone conserving stems in cementless hip arthroplasty. J Bone Joint Surg Am 2014;96(20):1742-52. https://doi.org/10.2106/JBJS.M.00780
3. Teoh KH, Lee PY, Woodnutt DJ. Our early experience of the Corin Minihip prosthesis. Hip Int 2016;16;26(3): 265-9. https://doi.org/10.5301/hipint.5000343
4. Ender SA, Machner A, Pap G, Hubbe J, Grashoff H, Neumann HW. Cementless CUT femoral neck prosthesis: increased rate of aseptic loosening after 5 years. Acta Orthop 2007;78(5):616-21. https://doi.org/10.1080/17453670710014301
5. Ender SA, Machner A, Pap G, Grasshoff H, Neumann HW. The femoral neck prosthesis CUT. Three- to six-year results. Orthopade 2006;35(8):841-7. https://doi.org/10.1007/s00132-006-0986-y
6. Ender SA, Machner A, Hubbe J, Pap G, Neumann HW. Medium-term results of the cementless femoral neck prosthesis CUT. Z Orthop Ihre Grenzgeb 2006;144(5):477-83. https://doi.org/10.1055/s-2006-942265
7. Ng VY, Arnott L, McShane MA. Perspectives in managing an implant recall: revision of 94 Durom Metasul acetabular components. J Bone Joint Surg Am 2011;93:e100(1-5). https://doi.org/10.2106/JBJS.J.01311
8. Rudert M, Leichtle U, Leichtle C, Thomas W. Implantation technique for the CUT-type femoral neck endoprosthesis. Oper Orthop Traumatol 2007;19(5-6):458-72. https://doi.org/10.1007/s00064-007-1018-4
9. Steens W, Skripitz R, Schneeberger AG, Petzing I, Simon U, Goetze C. Cementless femoral neck prosthesis CUT—clinical and radiological results after 5 years. Z Orthop Unfall 2010;148(4):413-9. https://doi.org/10.1055/s-0030-1250150
10. Thomas W, Lucente L, Mantegna N, Grundei H. ESKA (CUT) endoprosthesis. Orthopade 2004;33(11):1243-8. https://doi.org/10.1007/s00132-004-0717-1
11. Kendoff DO, Citak M, Egidy CC, O’Loughlin PF, Gehrke T. Eleven-year results of the anatomic coated CFP stem in primary total hip arthroplasty. J Arthroplasty 2013;28(6):1047-51. https://doi.org/10.1016/j.arth.2012.10.013
12. Briem D, Schneider M, Bogner N, Botha N, Gebauer M, Gehrke T, et al. Mid-term results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop 2011;35(5):655-60. https://doi.org/10.1007/s00264-010-1020-x
13. Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, Rorabeck CH. Soft-tissue balancing of the hip: the role of femoral offset restoration. Instr Course Lect 2005;54:131-41.
14. Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979;141:17-27. https://doi.org/10.1097/00003086-197906000-00002
15. Ghera S, Bisicchia S. The collum femoris preserving stem: early results. Hip Int 2013;23(1):27-32. https://doi.org/10.5301/HIP.2013.10718
16. Gill IR, Gill K, Jayasekera N, Miller J. Medium term results of the collum femoris preserving hydroxyapatite coated total hip replacement. Hip Int 2008;18(2):75-80. https://doi.org/10.1177/112070000801800202
17. Kress AM, Schmidt R, Nowak TE, Nowak M, Haeberle L, Forst R, et al. Stress-related femoral cortical and cancellous bone density loss after collumfemoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography. Arch Orthop Trauma Surg 2012;132(8):1111-9. https://doi.org/10.1007/s00402-012-1537-0
18. Molfetta L, Capozzi M, Caldo D. Medium term follow up of the Biodynamic neck sparing prosthesis. Hip Int 2011;21(1):76-80. https://doi.org/10.5301/hip.2011.6296
19. Nowak M, Nowak TE, Schmidt R, Forst R, Kress AM, Mueller LA. Prospective study of a cementless total hip arthroplasty with a collumfemoris preserving stem and a trabeculae oriented pressfit cup: minimun 6-year followup. Arch Orthop Trauma Surg 2011;131(4):549-55. https://doi.org/10.1007/s00402-010-1189-x
20. Pipino F, Molfetta L, Grandizio M. Preservation of the femoral neck in hip arthroplasty: results of a 13-17-year follow-up. J Orthop Traumatol 2000;1:31-9. https://doi.org/10.1007/s101950070026
21. Pipino F. CFP prosthetic stem in mini-invasive total hip arthroplasty. J Orthop Traumatol 2004;4(3):165-71.
https://doi.org/10.1007/s10195-004-0065-2
22. Rohrl SM, Li MG, Pedersen E, Ullmark G, Nivbrant B. Migration pattern of a short femoral neck preserving stem. Clin Orthop Relat Res 2006;448(448):73-8. https://doi.org/10.1097/01.blo.0000224000.87517.4c
23. Nieuwenhuijse MJ, Valstar ER, Nelissen RG. 5-year clinical and radiostereometric analysis (RSA) follow-up of 39 CUT femoral neck total hip prostheses in young osteoarthritis patients. Acta Orthop 2012;83(4):334-41. https://doi.org/10.3109/17453674.2012.702392
24. Pons M. Learning curve and short-term results with a short-stem CFP system. Hip Int 2010;20(Suppl 7):S52-7. https://doi.org/10.5301/HIP.2010.4443
25. Jerosch J, Grasselli C, Kothny PC, Litzkow D, Hennecke T. Reproduction of the anatomy (offset, CCD, leg length) with a modern short stem hip design—a radiological study. Z Orthop Unfall 2012;150(1):20-6. https://doi.org/10.1055/s-0030-1270965
26. Lindgren JU, Rysavy J. Restoration of femoral offset during hip replacement: a radiographic cadaver study. Acta Orthop Scand 1992;63:407-10. https://doi.org/10.3109/17453679209154755
27. González Della Valle A, Slullitel G, Piccaluga F, Salvati EA. The precision and usefulness of preoperative planning for cemented and hybrid primary total hip arthroplasty. J Arthroplasty 2005;20(1):51-8. https://doi.org/10.1016/j.arth.2004.04.016
28. Salvati EA, Sharrock NE, Westrich G, Potter HG, Valle AG, Sculco TP. The 2007 ABJS Nicolas Andry Award: three decades of clinical, basic, and applied research on thromboembolic disease after THA: rationale and clinical results of a multimodal prophylaxis protocol. Clin Orthop Relat Res 2007;(459):246-54. https://doi.org/10.1097/BLO.0b013e31805b7681
29. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737-55.
https://doi.org/10.2106/00004623-196951040-00012
30. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 1990;257:107-28.
https://doi.org/10.1097/00003086-199008000-00022
31. Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457-81. https://doi.org/10.1080/01621459.1958.10501452
32. 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. https://doi.org/10.3109/17453674.2014.908343
33. Hodge WA, Andriacchi TP, Galante JO. A relationship between stem orientation and function following total hip arthroplasty. J Arthroplasty 1991;6:229-35. https://doi.org/10.1016/s0883-5403(06)80169-5
34. Konyves A, Bannister GC. The importance of leg length discrepancy after total hip arthroplasty. J Bone Joint Surg Br 2005;87:155-7. https://doi.org/10.1302/0301-620X.87B2.14878
35. Steinberg B, Harris WH. The offset problem in total hip arthroplasty. Contemp Orthop 1992;24:556-62.
36. Nally FJ, Rossi LA, Diaz F, Stagnaro J, Slullitel PAI, Buttaro MA. Which prosthetic system restores hip biomechanics more effectively? Comparison among three systems. Curr Orthop Prac 2015;(26)4:382-6. https://doi.org/10.1097/BCO.0000000000000242
37. Wedemeyer C, Quitmann H, Xu J, Heep H, von Knoch M, Saxler G. Digital templating in total hip arthroplasty with the Mayo stem. Arch Orthop Trauma Surg 2008;128(10):1023-9. https://doi.org/10.1007/s00402-007-0494-5
38. Kim YH, Park JW, Kim JS. Ultrashort versus conventional anatomic cementless femoral stems in the same patients younger than 55 years. Clin Orthop Relat Res 2016;474(9):2008-17. https://doi.org/10.1007/s11999-016-4902-4
39. Wright JG, Einhorn TA, Heckman JD. Grades of recommendation. J Bone Joint Surg Am 2005;87(9):1909-10. https://doi.org/10.2106/JBJS.8709.edit
40. Vidalain JP. Twenty-year results of the cementless Corail stem. Int Orthop 2011;35:189-94. https://doi.org/10.1007/s00264-010-1117-2
41. Buttaro M, Martorell G, Quinteros M, Comba F, Zanotti G, Piccaluga F. Preservación ósea femoral con tallos cortos de fijación cervicometafisaria. Estudio radiográfico comparativo con tallos no cementados de fijación metafisaria. Rev Asoc Argent Ortop Traumatol 2015;79(4):232-6. http://www.scielo.org.ar/pdf/raaot/v79n4/v79n4a06.pdf