Medium-term comparison of results in obese patients and non-obese hip prostheses with Metha® short stem

Chammai, Y.; Brax, M.

doi:10.1007/s00590-014-1574-1

Cited by 18 publications

(30 citation statements)

References 26 publications

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“…The METHA stem demonstrated a mean survivorship of 95.9% (92% to 98%) with stem revision as the endpoint, at a mean follow-up of 4.5 years (2.8 to 5.8) in 556 hips. 33 – 36 Schnurr et al 37 investigated the METHA revision rate, distinguishing between monoblock and modular stems. In a population including 1090 monoblock stems, 314 modular stems with a titanium neck and 230 modular stems with a cobalt chrome neck, they reported a seven-year revision rate of 4.6% for both monoblock and modular cobalt chrome neck stems, and 7.5% for hips with modular titanium neck stems.…”

Section: Stem Features and Outcomesmentioning

confidence: 99%

“…The mean intra-operative peri-prosthetic fracture rate was 0.7% (0% to 2.4%) in 556 hips. 33 – 36 In one study of 250 hips, 36 the authors evaluated the coronal stem malalignment reporting valgus position (> 140°) in 5.6% of the hips, and varus position (< 130°) in 19.8%. The mean rate of > 2-mm stem subsidence was 1.3% (0.4% to 3.9%) in 550 hips 34 – 36 , 38 and the mean rate of stress shielding was 2.5% in 250 hips.…”

Section: Stem Features and Outcomesmentioning

confidence: 99%

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Uncemented short stems in primary total hip arthroplasty

Loppini

Grappiolo

2018

EFORT Open Reviews

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Over the last two decades, several conservative femoral prostheses have been designed. The goals of conservative stems include: the spearing of the trochanteric bone stock; a more physiological loading in the proximal femur reducing the risk of stress shielding; and to avoid a long stem into the diaphysis preventing impingement with the femoral cortex and thigh pain.All stems designed to be less invasive than conventional uncemented stems are commonly named ‘short stems’. However, this term is misleading because it refers to a heterogeneous group of stems deeply different in terms of design, biomechanics and bearing. In the short-term follow-up, all conservative stems provided excellent survivorship. However, variable rates of complications were reported, including stem malalignment, incorrect stem sizing and intra-operative fracture.Radiostereometric analysis (RSA) studies demonstrated that some conservative stems were affected by an early slight migration and rotation within the first months after surgery, followed by a secondary stable fixation. Dual-energy x-ray absorptiometry (DEXA) studies demonstrated an implant-specific pattern of bone remodelling.Although the vast majority of stems demonstrated a good osseointegration, some prostheses transferred loads particularly to the lateral and distal-medial regions, favouring proximal stress shielding and bone atrophy in the great trochanter and calcar regions.Cite this article: EFORT Open Rev 2018;3:149-159. DOI: 10.1302/2058-5241.3.170052

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Section: Stem Features and Outcomesmentioning

confidence: 99%

Section: Stem Features and Outcomesmentioning

confidence: 99%

Uncemented short stems in primary total hip arthroplasty

Loppini

Grappiolo

2018

EFORT Open Reviews

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“…Recent studies proved beneficial mid-term clinical results compared to conventional straight stems with decreased intraoperative complication rates [ 8 – 10 ]. These encouraging results led to the expansion of indications of short stems, including young and more active patients, elderly patients with reduced bone quality, and obese patients [ 11 – 13 ]. In addition, simultaneous bilateral implantation of a metaphyseal-anchoring short stem resulted in excellent clinical and satisfying radiological outcomes in the early stage [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of patient-related characteristics on early migration in calcar-guided short-stem total hip arthroplasty: a 2-year migration analysis using EBRA-FCA

et al. 2016

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BackgroundShort stems have gained popularity in recent years. Because of encouraging clinical results, indications have been expended from young to elderly and obese patients. However, long-term results are lacking. The purpose of this study was to evaluate the influence of gender, age, body weight, body mass index (BMI), and offset version on short-stem migration in correlation to the clinical outcome.MethodsThe implant migration of 202 metaphyseal-anchoring, calcar-guided short stems in 151 patients was assessed by “Einzel-Bild-Roentgen-Analyse” femoral component analysis (EBRA-FCA, femoral component analysis) in a 2-year follow-up. Full weight bearing was allowed directly after surgery. Patients were divided into groups regarding gender, age, body weight, BMI, and offset version. The Harris hip score (HHS) and satisfaction on visual analogue scale (VAS) were analyzed.ResultsAfter 2 years, mean axial subsidence of all 202 implants was 1.43 mm (standard deviation, SD 1.45 mm). A continuous reduction of initially pronounced subsidence over time could be observed. None of the stems had to be revised. Statistically significant increased rates of subsidence were seen in male (1.68 mm; SD 1.56 mm; p = 0.005) and heavy patients (1.54 mm; SD 1.48 mm; p = 0.022). No differences in implant migration were found regarding age, BMI, and different offset versions. HHS improved markedly from 45.8 (SD 15.9) to 98.1 (SD 4.7) while satisfaction on VAS improved from 1.8 (SD 2.2) to 9.7 (SD 0.9) after 2 years.ConclusionsThe results suggest a migration pattern with initially pronounced subsidence followed by subsequent stabilization. Male and obese patients show a slightly increased initial subsidence without any signs of sustained micromovement. No correlation was found concerning clinical results and pronounced initial subsidence above the threshold of 1.5 mm. No aseptic loosening or other signs of implant failure were seen within the observation period of 2 years.Trial registrationGerman Clinical Trials Register, DRKS00009834.

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“…Selection, detection and performance bias were found in 10 out of the 12 papers (83.3%), 7,20–24,26–29 while selection, detection, performance and attrition bias were found in 2 out of the 12 papers (16.7%). 19,25 Conflict of interest was reported in 8 out of the 12 papers (66.7%) (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Supine position was exclusively or partially used in 9 studies (75%), 7,21–26,28,29 whereas 4 studies (33.3%) made use of lateral decubitus position either for some or all of their patients (Table 4). 19,20,23,27…”

Section: Resultsmentioning

confidence: 99%

The clinical outcome of the Metha short hip stem: a systematic scoping review

Malahias

Tejaswi²,

Chytas

et al. 2020

HIP International

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Introduction: Short femoral stems were designed to bridge the gap between conventional straight design stems and hip resurfacing prostheses in total hip arthroplasty (THA). A number of clinical trials have been recently conducted to assess the clinical and safety profile of the cementless, colarless, tapered Metha short hip stem in young or active middle-aged individuals. Methods: A systematic scoping review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. 4 reviewers independently conducted the search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “short” AND “hip” AND “stem”. Results: From the initial 773 studies we finally chose 12 studies after applying our inclusion-exclusion criteria. The number of operated hips that were included in these studies was 5048 (mean BMI range: 22.7–35.2, mean age range: 44.4–60.4 years, mean follow-up range: 2–9 years). The mean modified Coleman methodology score was 52.3/100, while it ranged from 31/100 to 63/100. All mean clinical outcome scores that were used in the studies illustrated significant postoperative improvement when compared with the respective initial values. The revision rate of the Metha stem for component-related reasons was 2.5%, while the rate of major complications not requiring revision of the Metha stem was 2.8%. Conclusions: The Metha stem performs well in young or active middle-aged THA patients. Further studies are required for the assessment of the long-term results.

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Medium-term comparison of results in obese patients and non-obese hip prostheses with Metha® short stem

Abstract: The Metha® prosthesis can be implanted at the forefront of primary total hip arthroplasty in normal subjects as well as in obese subjects. However, we cannot yet claim we will reach the same durability we experience with standard prostheses.

Cited by 18 publications

References 26 publications

Uncemented short stems in primary total hip arthroplasty

Uncemented short stems in primary total hip arthroplasty

Influence of patient-related characteristics on early migration in calcar-guided short-stem total hip arthroplasty: a 2-year migration analysis using EBRA-FCA

The clinical outcome of the Metha short hip stem: a systematic scoping review

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