Nouvelle tige fémorale courte en arthroplastie de la hanche – suivi clinique à 2 ans minimum

Abstract

Purpose Total hip arthroplasty (THA) has recently evolved regarding the design of the femoral stem. Manufacturers and surgeons are developing shorter stems in order to preserve femoral bone stock, adapt to minimally invasive surgical approaches, reduce thigh pain and facilitate revision. We present the minimum two-year follow-up of the first 285 THA using a short, uncemented, titanium grit blasted femoral stem with a curved, rectangular, tri-tapered shape. Methods This cohort consists of a non-selected consecutive series of patients in whom the short femoral stem was implanted at two hospitals. Two hundred and eighty-five THA were performed in 275 patients (136 women, 139 men) with an average age of 63.9 years and BMI of 28.1. The surgery was performed trough a mini posterior or antero-lateral surgical approaches. Osteoarthitis was the primary indication in 82%. Results At minimum two years, the mean WOMAC index was 7 and the Harris Hip Score was 96 (pain score 43). Alignment of stem was within 5 degrees of neutral alignment in 87%. One stem showed subsidence of 2 mm, but bony integration was seen at last follow-up. Cortical hypertrophy was seen once, and no patients complained of thigh pain. There were 7 (2.5%) intraoperative femoral fissures stabilized with cables, one case of dislocation, no infection, 2 traumatic postoperative periprosthetic fractures, one of which needed revision with a standard primary stem and one cup tilt following a fall. Conclusions This short femoral stem can fit most patient anatomies and is mini-approach friendly. Revision with a standard primary stem was easily performed for the periprosthetic fracture, limiting bony violation. The early clinical results are promising. An ongoing RSA study should confirm stability of the stem.