Abstract
The current concepts of proximal femoral fixation in hip arthroplasty can be divided into three groups: the surface replacement concept, the femoral neck prostheses, and the short stems prostheses.
Between 1999–2004 more than 500 short stems prostheses (Mayoä) were implanted at the Orthopaedic department of the Martin-Luther-University, Halle, Germany.
To investigate the early functional results, a prospective randomized study was performed comparing 40 cementless short stem prostheses (Mayoä 1) with 40 cementless anatomical standard stem prostheses (ABGä 2) implanted in patients with unilateral hip osteoarthritis.
Age, gender, diagnoses, and body mass index showed no significant difference between both groups. In all patients, an uncemented acetabular press-fit cup was used. The implantations were performed by 4 orthopaedic consultants. A standardized anterolateral approach to the hip was used in all cases. In the short stem group, the femoral neck was preserved to achieve a multi-point fixation of the double-tapered stem in the intertrochanteric region.
The patients were followed clinically and radiographically at 3, 6, and 12 months postoperatively. Differences between both groups were tested using Student’s t-test. No specific complications occurred neither during surgery nor during the follow-up (FU). No patient was lost for FU. The radiograhic FU showed a correct implant position in all cases.
Concerning the Harris hip score (HHS), a statistically significant difference (< 0.01) was found at 3 months: the HHS for the short stem group averaged 93.87 points (range, 60–100 points), for the ABG group 87.02 points (range, 60–100 points). Preoperatively, at 6, and at 12 months, no statistically significant difference could be found between both groups.
In this study, patients having a short stem prosthesis returned faster to work and normal daily activities. We attribute this to the femoral neck approach without involvement of the greater trochanter and the abductor muscles. With its good functional results and its bone-saving concept, the short stem is an attractive design particularly for young patients.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
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