1. Better Early Functional Outcome after Short Stem Total Hip Arthroplasty?
L.W.A.H. van Beers MSc 1, V.A.B. Scholtes PhD 1, J. van Oldenrijk MD 2, C.H. Geerdink MD PhD 3, B.B.A.M. Niers MD 3, M. Bhandari MD PhD 4, R.W. Poolman MD PhD 1
1 Department of Orthopaedic Surgery, Joint Research, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, the Netherlands
2 Department of Orthopaedic Surgery, Academic Medical Center (AMC), Amsterdam, The Netherlands
3 Department of Orthopaedic Surgery, Ikazia Hospital, Rotterdam, The Netherlands
4 Department of Surgery, McMaster University Hospital, Hamilton, Ontario, Canada
Background
Results
Short Collum Femoris Preserving (CFP) prosthesis stems follow the anatomical structure of the femoral neck, which minimizes the risk of tissue damage in total hip arthroplasty (THA). Theoretically, faster functional recovery could be obtained compared to THA with a conventional straight stem.
A total of 150 patients were randomised
At 2 years follow-up, 3 patients were lost to follow-up
Demographics
Mean (SD)
Age, y (mean, sd)
60 (7)
BMI, kg/l2 (mean, sd)
27 (4)
Gender, % (F: M)
71 : 29
ASA, % (I : II: III)
42 : 55 : 3
Objectives
To compare the short term functional results on the Hip disability and Osteoarthritis Outcome Score (HOOS) between uncemented THA with a short CFP and a conventional straight stem at 3 months, 1 and 2 year postoperative.
Mean HOOS significantly improved in the entire group from 37±15 points at baseline to 71±13 points (3 months), 81±15 points (1 year) and 80±16 points (2 year). See figure 3.
All other outcomes also improved significantly over time for the whole group
No significant difference was observed between the different types of prosthesis
Figure 1. Zweymuller stem
Figure 2. Collum Femoris Preserving Stem
Methods
Prospective, maximally blinded, randomised controlled multicenter trial
Inclusion criteria:
hip osteoarthritis BMI
18-70y
BMI<40
life expectancy >5y
anatomical integrity of the femoral neck
Randomization was performed in the OR
Alloclassic Zweymuller stem (Zimmer, Warsaw, USA) (figure 1) or
CFP stem (Waldemar Link, Hamburg, Germany) (figure 2)
Primary outcome: Dutch version of the HOOS
Secondary outcomes:
Harris Hip Score
Physical Component Scale of the SF12
Timed Up and Go test
Patients, researchers and data-analysts were blinded for type of prosthesis.
Figure 3. Primary results: mean HOOS scores at baseline, 3 months , 1 and 2 year postoperative.
* = p<0.05, CFP = Collum Femoris Preserving
Conclusion
We found no evidence for a better short term functional result after short stem THA compared to conventional straight stem THA
Disclosures: Department of Orthopaedic Surgery of OLVG received a research grant from LINK Nederland.