Comparative study of revision hip arthroplasty after short stem versus after conventional stem

Abstract

ObjectiveTo compare clinical and radiological outcomes in revision total hip arthroplasty (THA) after short-stem versus conventional-stem THA.BackgroundShort-stem THA aims to preserve the proximal bone stock for future revisions, so that the first revision resembles a primary intervention rather than a revision.Patients and methodsThis study included 30 patients with revision THA divided into two groups (15 each); group A: revision after short stem and group B: revision after conventional stem. The studied groups were compared regarding 31 variables including demographic data, details of the primary and revision procedures, postoperative radiological subsidence, hospital stay, time for full weight bearing, and preoperative and postoperative clinical scores.ResultsEarly stem subsidence (40%) was the main indication of revision in group A compared with periprosthetic femoral fractures (73.3%) in group B (P = 0.021). The mean time to revision was significantly shorter in group A (15 months) compared with 95.33 months in group B (P = 0.005). The mean operative time, blood loss, postoperative blood transfusion, and hospital stay were significantly lower in group A compared with group B (P < 0.001, P < 0.001, P = 0.002 and P = 0.001, respectively). Revisions in group A were performed using either short stems (13.3%) or conventional stems (86.7%) while 80% of patients needed long stems and 20% of patients needed conventional stems in group B (P < 0.001).ConclusionThe most common cause of failure of short stems is early stem subsidence. Short-stem THA has specific indications, and patient selection is very crucial. Revision of short-stem THA resembled the primary THA.