Minimally Invasive Anterolateral Approach Total Hip Arthroplasty Using Bone Preserving Short Femoral Stem: Intermediate Term Clinical and Radiological Results

Abstract

Aim: The objective of this study was to evaluate the intermediate term clinical and radiological results of a Bone preserving short stem hip implant being operated through a minimally invasive anterolateral hip approach. Methods: In 20 consecutive patients suffering from osteoarthritis with 25 affected hip joints (five cases were bilateral), the clinical and radiological results of 25 hip arthroplasties performed in one hospital between October 2009 and May 2014 through a minimally invasive anterolateral approach using a cementless short stem prosthesis type Aida and a cementless cup type Ecofit with a ceramic-on-ceramic pairing were evaluated prospectively. The median age of patients at time of surgery was 60 years (range, 42-71 years), 15 male (4 were bilateral) and 5 female patients (one was bilateral) were included in the study. The median clinical follow up was 30 months (range, 2-88 months) and the median radiological follow up was 30 months (range, 2-88 months). Results: Harris Hip Score improved from a median preoperative value of 53 to a median postoperative value of 96 (range, 73-100) at follow up. 22 hips (88%) showed an excellent postoperative Harris Hip Score, 2 hips (8%) a good postoperative Harris Hip Score and one hip (4%) a fair postoperative Harris Hip Score. Only two patients complained of postoperative thigh pain. Regarding patient satisfaction, 15 patients (60%) were very satisfied, 10 patients (40%) were satisfied. None was unsatisfied. Radiological analysis showed that 19 stems (76%) were with stable bony ingrowth, two cases (8%) showed stable fibrous ingrowth. Four cases need further follow up for proper evaluation of stem fixation. Conclusion: The intermediate term survival of the Aida short stem hip implant being operated through a minimally invasive anterolateral hip approach is very promising and achieving the goals of a standard hip arthroplasty.