Although the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index was originally developed for the assessment of non-operative treatment, it is commonly used to evaluate patients undergoing either total hip (THR) or total knee replacement (TKR). We assessed the importance of the 17 WOMAC function items from the perspective of 1198 patients who underwent either THR (n = 704) or TKR (n = 494) in order to develop joint-specific short forms. After these patients were administered the WOMAC pre-operatively and at three, six, 12 and 24 months’ follow-up, they were asked to nominate an item of the function scale that was most important to them. The items chosen were significantly different between patients undergoing THR and those undergoing TKR (p < 0.001), and there was a shift in the priorities after surgery in both groups. Setting a threshold for prioritised items of ≥ 5% across all follow-up, eight items were selected for THR and seven for TKR, of which six items were common to both. The items comprising specific WOMAC-THR and TKR function short forms were found to be equally responsive compared with the original WOMAC function form.

Cite this article: Bone Joint J 2013;95-B:239–43.

Purpose: More and more younger patients needs primary hip replacement. Specially for these patients the so called calcar prosthesis have been enveloped; short ste ms with fixation, bone incrow and loading only in the proximal parts of the femur.

Using these type of prosthesis in cases of primary operation, later on in cases of first revision the so called standard prosthesis can be used.

Materials and methods: We have experience with more than 500 calcar prosthesis type MAYO in the last 4 years. The indication for operation in these group of patients is different to the older patients group; the younger patients needs hip replacement because of rheumatic diseases, dysplasia or femoral head necrosis.

The mean age of these patients is below 50 years.

The implantations have been done by an modified anterolateral Watson Jones approach. Especially for the use of the MAYO stem we developed a minimal invasive operation technique to provide any trauma to the gluteal muscles.

All the cases we have done are under clinical and radiological follow up.

Results: Reporting all our cases according to the Harris-Hip-Score, we saw go od and excellent results; especially the good functional results could be reached in a short period of time after the operation.

We have seen less complications by using the MAYO stem in comparison to the group of patients with our standard hip stems.

95% of the operations could be done without any incision to the gluteal muscles at the greater trochanter of the femur; the mean length of skin incision has been less than 8 cm.

The x-ray follow up shows in none of our cases any osteolysis in the region of the calcar femoris.

Conclusion: With the MAYO Hip System from our point of view good and excellent results can be reached; especially in cases of younger patients these type of short stem hip prosthesis should be used. The primary hip replacement therefore can be done with an minimum of bone lost at the calcar and with an maximum of atraumatic operation technique to the soft tissue around the hip joint.