Cementless short stem hip arthroplasty METHA® as an encouraging option in adults with osteonecrosis of the femoral head

Floerkemeier, Thilo; Tscheuschner, Nora; Calließ, Tilman; Ezechieli, Marco; Floerkemeier, Stephanie; Budde, Stefan; Windhagen, Henning; Lewinski, Gabriela von

doi:10.1007/s00402-012-1524-5

Cited by 57 publications

(63 citation statements)

References 31 publications

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“…Based on their results, they concluded that the Mayo Ò conservative hip is an alternative for operative treatment of ONFH. These results can be confirmed by clinical and radiological follow-up after implantation of the METHA short stem [51]. The outcome of the METHA Ò short-stem arthroplasty in 74 hips of 64 patients with ONFH showed an increase of the HHS from 37.7 preoperatively to 89.3 points after a mean follow-up of 34 months.…”

Section: Minor Bone Quality In the Femoral Neck In Onfh?supporting

confidence: 76%

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Floerkemeier

Budde

Gronewold

et al. 2015

Arch Orthop Trauma Surg

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The short- to medium-term results show predominantly good outcomes. However, due to differences in the design of short stems and their fixation, it is hard to draw a general conclusion. Short stems with primary diaphyseal fixation do not reveal a high increased risk of failed osseointegration or loosening. For designs with a primary metaphyseal anchorage, an MRI should be conducted to exclude that the ostenecrosis exceeds the femoral neck.

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Section: Minor Bone Quality In the Femoral Neck In Onfh?supporting

confidence: 76%

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Floerkemeier

Budde

Gronewold

et al. 2015

Arch Orthop Trauma Surg

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“…Once irreversible collapse of the articular surface has taken place, according to the existing literature, attempts to preserve the femoral head are less successful and better results are achieved through joint-replacing techniques [1, 10–12]. Common joint-replacement treatments include hip resurfacing, total hip arthroplasty (THA) and short stem THA [13–18]. High failure and complications rates have been reported for both hemi-resurfacing and total hip resurfacing [10, 13, 19, 20], therefore total hip resurfacing is now considered a valuable option only for restricted indications [21, 22].…”

Section: Introductionmentioning

confidence: 99%

Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study

Capone

Bienati

Torchia

et al. 2017

BMC Musculoskelet Disord

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BackgroundIn young patients with osteonecrosis of the femoral head (ONFH), short-stem total hip arthroplasty (THA) could allow a potential advantage in preserving metaphyseal bone-stock, when revision surgery might become necessary. However, only a few studies have evaluated the outcome of short-stem THAs in ONFH. We reviewed the prospectively collected data of a cementless partial neck-retaining short-stem with ceramic-on-ceramic bearings in ONFH patients.MethodsThirty patients (37 hips) younger than 60 years (mean age at surgery, 51.5 years) underwent THA with the NANOS® stem (Smith and Nephew, Marl, Germany) from January 2006 to December 2012. All patients received a 32-mm or 36 mm ceramic femoral head. Harris hip score, WOMAC and UCLA activity score were recorded. Postoperative radiographs were evaluated for bone-implant fixation and osteolysis. Further analysis correlated clinical findings with implants characteristics and patient demographics at mean 5.6 years’ follow-up (range, 3–10 years).ResultsThe clinical and functional results improved significantly (p < 0.001). At latest follow-up, mean HHS, WOMAC, and UCLA activity scores were 90 (range, 71–100), 94 (range, 76–100), and 6.3 (range, 4–10) points, respectively. The diameter of the femoral head did not influence the clinical outcome (p = 0.661). All hips showed bone ingrowth fixation of the acetabular and femoral components. No patients showed osteolysis. No revision for any reason was performed during the study period.ConclusionsThe excellent clinical results and fixation pattern at mean 5.6 years’ follow-up reveal this implant as a reliable option in advanced stage of ONFH either. Further investigations are crucial to determine the long-term durability and to assess whether the association of ceramic-on-ceramic bearings, can be useful to achieve longer survivorship and lower complications rates.Trial registrationRegistry number: ISRCTN 91336248; date of registration: 04/07/2017.

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“…5 The mid-term outcome of THA using a short stem has been excellent. 2,3,[6][7][8][9] Restoration of the hip anatomy (such as femoral offset and leg length) after THA leads to improved functional outcome. 10 Restoration of the femoral offset (the distance from the centre of the femoral head to the line bisecting the long axis of the femur) improves hip abductor strength11 and range of motion, 11,12 and decreases limping, 13 dislocation risk, 14 cup strain, and polyethylene wear.…”

Section: Introductionmentioning

confidence: 99%

Total Hip Arthroplasty Using a Short-Stem Prosthesis: Restoration of Hip Anatomy

Amenábar

Marimuthu

Hawdon

et al. 2015

J Orthop Surg (Hong Kong)

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Purpose. To evaluate hip parameters such as vertical centre of rotation (VCR), horizontal centre of rotation (HCR), femoral offset, and leg length after total hip arthroplasty (THA) using the Nanos short-stem prosthesis. Methods. Medical records of 73 men and 74 women aged 25 to 92 (mean, 63) years who underwent THA using the Nanos short-stem prosthesis by a single surgeon were reviewed. Prior to the surgery, the optimal cup and stem size, head length, and level of the neck osteotomy were determined using radiographs. Intra-operatively, the leg length and femoral offset were checked, and the level of neck resection and head length were adjusted. VCR, HCR, femoral offset, and leg length of the operated and contralateral sides were compared. Functional outcomes were assessed using the Harris Hip Score (HHS). Results. Compared with the normal contralateral hips, the operated hips had a mean increase of 0.4Total hip arthroplasty using a short-stem prosthesis: restoration of hip anatomy mm in VCR (p=0.032), a mean decrease of 1.4 mm in HCR (p=0.027), a mean increase of 0.6 mm in femoral offset (p=0.043), and a mean increase of 0.36 mm in leg length (p=0.035). For these respective parameters, the difference between the normal contralateral side and the operated side was within 5 mm in 89%, 80%, 71%, and 96% of patients. The HHS improved from a mean of 53 to 91 at one year (p<0.001). Conclusion. THA using the Nanos short-stem prosthesis enabled restoration of hip anatomy (VCR, HCR, femoral offset, and leg length).

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Cementless short stem hip arthroplasty METHA® as an encouraging option in adults with osteonecrosis of the femoral head

Abstract: The study confirms encouraging results as well as good bone ingrowth of the cementless short stem arthroplasty METHA(®) even in patients with osteonecrosis.

Cited by 57 publications

References 31 publications

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Short stem total hip arthroplasty for osteonecrosis of the femoral head in patients 60 years or younger: a 3- to 10-year follow-up study

Total Hip Arthroplasty Using a Short-Stem Prosthesis: Restoration of Hip Anatomy

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