Abstract
Introduction
Short-stem hip arthroplasty is gaining popularity as a method of treating hip arthritis in biologically younger patients. The potential benefit of using a short-stem is preservation of bone in the proximal femur for a future revision. We have compared the early clinical and radiological results of a short-stem hip arthroplasty versus a conventional total hip arthroplasty (THA) using a standard length femoral prosthesis with particular focus on functional outcome.
Methods
We evaluated a prospectively collected data on consecutive series of 249 patients, who underwent uncemented total hip arthroplasty at our institution. They were distributed into 2 groups: Group I, 125 patients received an uncemented short femoral stem (Mini Hip Arthroplasty (MHA), Corin, Cirencester) and Group II, 124 patients received a conventional uncemented femoral stem (Accolade, Stryker, Michigan) with mean follow up of 3.2 years (2–4). The characteristics of the two groups have been presented in Table I. Evaluation was based on plain radiographs performed at 6 months, 1 year and 2 years postoperatively, while their clinical status was assessed using the modified Harris hip score (mHHS) preoperatively and postoperatively at 6 weeks, 6 months, 1-year, 2-years and annually thereafter.
Results
The outcome measures and complications in the two groups are presented in Table II. The mHHS was split into their two components (pain and function) to evaluate any differences between the groups. The postoperative results for pain were similar in both groups (p > 0.05), but the functional element of mHHS was significantly better (p < 0.05)* in Group I compared to Group II. This difference however did not reach the level of the minimum clinically important difference. All femoral stems showed radiographic evidence of bony ingrowth. No evidence of stem subsidence was found in any of the patients. One femoral implant was revised for infection in Group II.
Conclusion
Our study suggests that the results of short-stem hip arthroplasty are comparable to conventional uncemented THA in the short-term. The functional outcome scores appear to be better in the short-stem group compared to the conventional group, but the difference is not clinically relevant. Short-stem hip arthroplasty can be an optimal choice for use in younger patients with good bone quality, who are expected to require revision in the future.
