Neck-sparing short femoral stems: A meta-analysis

Sivaloganathan, Sivan; Maillot, Cédric; Harman, Ciara; Villet, Loïc; Rivière, Charles

doi:10.1016/j.otsr.2020.05.004

Cited by 25 publications

(11 citation statements)

References 44 publications

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“…This outcome could be explained also by the smaller mean age of the patients of the minima cohort. Similar results were recorded in a more recent comparative meta-analysis regarding primary THA between 616 neck sparing short stems and 643 standard stems, conducted by Sivaloganathan et al Specifically, they reported no statistically significant discrepancies in terms of functional outcomes, thigh pain, and dislocation or revision rates [ 57 ]. Another recent meta-analysis did not record significant discrepancies between short and standard femoral stems in terms of functional outcomes, except the anterior thigh pain which was associated with the conventional stems [ 26 ].…”

Section: Discussionsupporting

confidence: 80%

MINIMA Short Stem Versus Standard Profemur (TL) Stem in Primary Total Hip Replacement: A Comparative Study

Tottas¹,

Ververidis²,

Kougioumtzis³

et al. 2022

Cureus

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Background: The objective of our study was to compare a novel squared section, tapered design - with four conicity - short stem, the MINIMA® short stem with the cementless Profemur® TL standard femoral stem in primary total hip arthroplasty (THA) in terms of functional outcomes, radiologic evaluation and other peri-operative and post-operative data. Material and methods: This is a comparative study including 46 patients undergoing primary THA. In 23 patients, the MINIMA® short stem was used. These patients were matched with another 23 patients in whom a cementless Profemur® TL standard femoral stem was used. The levels of the pain were evaluated according to the Visual Analog Scale/Numerical Rating Scale (VAS/NRS). The functional and clinical evaluation of the patients was performed with Harris Hip Score (HHS), Charnley’s Hip score, EuroQol (EQ-5D)-(EQ-100), Patient Health Questionnaire (PHQ-9), and neuropathic pain questionnaire (DN-4). The rest of the comparison data included demographic data, the American Society of Anesthesiologists score (ASA), Charlson Index score, the pre-operative diagnosis, radiographic evaluation, the days of hospitalization, the operating time, incision length, blood loss, and blood transfusion requirements and complication rates. Results: The two cohorts had comparable results regarding all patients’ peri-operative data. The radiographic assessment revealed considerable higher levels of femoral offset and femoral subsidence for the MINIMA group, but within acceptable limits for both cohorts. The majority of the functional and other scores did not give strong prominence to one specific femoral stem. Conclusion: Our comparative study underlined the efficacy of the MINIMA® short stem, due to the fact that it revealed comparable and, in some cases, relatively better short-term outcomes compared with the TL standard femoral stem. Yet, more well-designed long-term research is required in order to further establish its effectiveness.

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Section: Discussionsupporting

confidence: 80%

MINIMA Short Stem Versus Standard Profemur (TL) Stem in Primary Total Hip Replacement: A Comparative Study

Tottas¹,

Ververidis²,

Kougioumtzis³

et al. 2022

Cureus

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“…Furthermore, given a facilitated and less traumatic implantation technique, intraoperative blood loss can be reduced [ 18 ]. Recent studies provided beneficial mid-term clinical results of uncemented short stems compared to conventional stem designs along with decreased intraoperative complication rates [ 19 , 20 , 34 , 35 ]. Especially neck-sparing short stems seem to have better maintenance of bone mineral density changes compared to conventional implants [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies provided beneficial mid-term clinical results of uncemented short stems compared to conventional stem designs along with decreased intraoperative complication rates [ 19 , 20 , 34 , 35 ]. Especially neck-sparing short stems seem to have better maintenance of bone mineral density changes compared to conventional implants [ 35 ]. Furthermore, there are promising results regarding micromotion in vitro measurements, as well as clinical mid-term results of stem migration patterns and patient-reported outcome measures [ 24 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Biomechanics of a cemented short stem: a comparative in vitro study regarding primary stability and maximum fracture load

Freitag

Kutzner

Bieger

et al. 2021

Arch Orthop Trauma Surg

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Purpose In total hip arthroplasty, uncemented short stems have been used more and more frequently in recent years. Especially for short and curved femoral implants, bone-preserving and soft tissue-sparing properties are postulated. However, indication is limited to sufficient bone quality. At present, there are no curved short stems available which are based on cemented fixation. Methods In this in vitro study, primary stability and maximum fracture load of a newly developed cemented short-stem implant was evaluated in comparison to an already well-established cemented conventional straight stem using six pairs of human cadaver femurs with minor bone quality. Primary stability, including reversible micromotion and irreversible migration, was assessed in a dynamic material-testing machine. Furthermore, a subsequent load-to-failure test revealed the periprosthetic fracture characteristics. Results Reversible and irreversible micromotions showed no statistical difference between the two investigated stems. All short stems fractured under maximum load according to Vancouver type B3, whereas 4 out of 6 conventional stems suffered a periprosthetic fracture according to Vancouver type C. Mean fracture load of the short stems was 3062 N versus 3160 N for the conventional stems (p = 0.84). Conclusion Primary stability of the cemented short stem was not negatively influenced compared to the cemented conventional stem and no significant difference in fracture load was observed. However, a clear difference in the fracture pattern has been identified.

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“…1,2 Short-stem hip prostheses were introduced in the 1990s with a view to: (1) reducing surgical invasiveness; (2) preserving bone stock and facilitating future revisions; (3) restoring hip biomechanics and providing physiological loading in the proximal femur, thereby reducing the risk of stress shielding. [3][4][5][6][7] Short stems are defined as (1) stems <130 mm in length, (2) occupying the neck, the metaphysis and the proximal borderline aspect between the metaphysis and the diaphysis. [3][4][5][6][7] The Collum Femoris Preserving stem (CFP, Waldemar Link, Hamburg, Germany) is 1 of the first short hip stem prostheses (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7] Short stems are defined as (1) stems <130 mm in length, (2) occupying the neck, the metaphysis and the proximal borderline aspect between the metaphysis and the diaphysis. [3][4][5][6][7] The Collum Femoris Preserving stem (CFP, Waldemar Link, Hamburg, Germany) is 1 of the first short hip stem prostheses (Figure 1). 8,9 The CFP stem is made of Tilastan [titanium, 6 aluminum, 4 vanadium (Ti-6Al-4VA)].…”

Section: Introductionmentioning

confidence: 99%

A 24-year single-centre experience with Collum Femoris Preserving stem: clinical and radiological results in young and elderly population

et al. 2022

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Objective: The primary aim was to evaluate the long-term follow-up of Collum Femoris Preserving (CFP) stem, specifically focusing on stem survivorship, complications, as well as on clinical and radiological results. The secondary study objective is an age-based sub-analysis (<65 years vs. ⩾65 years) of long-term results. Materials and methods: We performed a retrospective analysis of patients who underwent CFP implantation between 1997 and 2009. A total of 311 patients (342 hips) were included with a mean follow-up of 15.8 ± 2.2 (range 11–24) years. 2 age groups were analysed: Group-Y (age <65) and Group-E (age ⩾65). Group-Y included 182 hips (mean follow-up 16.3 ± 4.2 years), whereas Group-E included 160 hips (mean follow-up 15.5 ± 3.7 years). Clinical (HHS, OHS and VAS) and radiological data were obtained at final follow-up. Any complications, reoperations, prosthetic components revisions and stem revisions were analysed. Results: According to HSS score, 95% of patients reported excellent/good results (95.6% Group-Y vs. 94.4% Group-E) with an overall stem survival rate of 93.3% (94% Group-Y vs. 92.5% Group-E; p = 0.37). Overall, 87% of stem revisions were performed with primary stems. The rate of prosthetic components revision was 9.9 % (9.9% in Group-Y vs. 10% in Group-E; p = 1). The reoperation rate was 10.8% (11.5% in Group-Y vs. 10.0% in Group-E; p = 0.73). Conclusions: The CFP stem provides good clinical and radiological long-term results with low rate of complications in both young and elderly patients. No significant difference in stem revision and reoperation rates was observed between the 2 groups. Both in elderly and young patients, CFP stem allows revisions to be performed with primary stems.

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Neck-sparing short femoral stems: A meta-analysis

Cited by 25 publications

References 44 publications

MINIMA Short Stem Versus Standard Profemur (TL) Stem in Primary Total Hip Replacement: A Comparative Study

MINIMA Short Stem Versus Standard Profemur (TL) Stem in Primary Total Hip Replacement: A Comparative Study

Biomechanics of a cemented short stem: a comparative in vitro study regarding primary stability and maximum fracture load

A 24-year single-centre experience with Collum Femoris Preserving stem: clinical and radiological results in young and elderly population

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