Survivorship, complications and patient-reported outcomes in calcar-guided short-stem THA: prospective mid-term multicenter data of the first 879 hips

Kutzner, Karl Philipp; Maurer, Steven M.; Meinecke, Ingmar; Heers, G.; Bosson, Dominique

doi:10.1007/s00402-022-04354-z

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…In our own cohort we also observed the highest subsidence within the rst 3 months but unlike as Kutzner et al we detected further subsidence thereafter up to the latest follow-up at 10 years, whereas notably the amount of additional subsidence was very little. In line with other studies the amount of subsidence did not correlate with clinical outcome at latest follow-up 10,[23][24][25] . Again, like other studies reporting on mid-term outcomes of calcar-guided short stems age, bodyweight and BMI did not in uence subsidence.…”

Section: Discussionsupporting

confidence: 90%

“…Several studies have reported good short-to midterm results for the optimys™ stem (Mathys Ltd., Bettlach, Switzerland) in osteoarthritis with high patient satisfaction 9,10 and a survivorship of 98.4-100% at mid-term follow-up 11,12 . In addition, a 96.2% survivorship was reported for femoral neck fractures 13 and even 100% survivorship for osteonecrosis 14 , all at midterm investigating the same stem.…”

Section: Introductionmentioning

confidence: 99%

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Subsidence rate and long-term outcome of a calcar-guided short stem: A prospective 10-year follow-up study

Thut,

Rohner,

Kellner

et al. 2024

Preprint

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Background: Several studies have reported good to excellent mid-term outcomes for various types of calcar-guided or metaphyseal-anchoring short stems. In our current long-term study, we investigated the subsidence rate of the optimys stem at 10-year follow, correlated the data with clinical outcome and identified potential risk-factors for failure. Methods: In our cohort we included 41 patients with 43 hips with an average age of 62.5 years and a minimum follow-up of ten years. Ein-Bild-Roentgen-Analyse (EBRA) was used to detect potential subsidence. Clinical outcome and complication rate were analyzed. Results: We found an average subsidence of 0.66 mm (SD 0.60) at 3 months, 0.92 (SD 0.88) at 12, 1.5 (SD 1.19) at 60 and 1.8 (SD 1.47) at 120 months respectively. We identified increased femoral offset (2.19mm vs 0.90 p = 0.0099) and head size (28, 0.34mm vs. 32 1.48 Vs. 36 2.50, p = 0.0052), as well as gender (female 1.21mm vs. male 2.35, p = 0.0067) as risk factors for increased subsidence. The amount of subsidence did not impact clinical outcome. Conclusions: The evaluated calcar-guided short stemshows an average subsidence of 1.8mm at 10-year follow up, with most pronounced subsidence within the first 3 months and stabilizing thereafter. In our study male gender and offset seem to be more susceptible to pronounced subsidence whereas this did not correlate with revision rate or inferior clinical outcome in terms of Harris Hip Score (HHS), patient satisfaction and pain. Trial registration: This prospective study was approved by the ethics commission board of northwest- and central- Switzerland (BASEC Nr 2023-00375).

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Subsidence rate and long-term outcome of a calcar-guided short stem: A prospective 10-year follow-up study

Thut,

Rohner,

Kellner

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In 2022, Kutzner et al [ 18 ] published a study on the mid-term results of the Optimys hip stem for 782 patients at 6 years of follow-up. It showed a survival rate of 98.4%, with 26 revisions in total (including infection and acetabular cup malposition), of which 14 were stem revisions.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, both studies had comparable baseline characteristics of the patients. Kutzner et al [ 18 ] used the Harris Hip Score (HHS) as a functional outcome measure. The HHS is used to evaluate the function of the hip before and after surgery for a range of different disabilities[ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Mid-term survival of the Optimys short stem: A prospective case series of 500 patients

Hamans,

de Waard,

Kaarsemaker

et al. 2024

World J Orthop

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BACKGROUND In recent years, there has been an increase in the number of total hip arthroplasty procedures in the younger patient population. This active group has higher expectations of their prosthesis in comparison to the older population, and there is a greater physical demand for the prosthesis. Short femoral stems were introduced to retain proximal bone stock and joint biomechanics and became more common to implant in this specific population. Currently, the long-term survival and functional outcomes of various short stems are still being investigated in different clinics. AIM To determine the 5-year survival of the Optimys hip stem. METHODS This was a prospective multicenter cohort study of 500 patients conducted in two hospitals in the Netherlands. All patients received the Optimys short stem (Mathys Ltd, Bettlach, Switzerland). The primary outcome measure was survival of the hip stem, with revision as the endpoint. The secondary outcome measurements included patient-reported outcome measures (PROMs). Kaplan-Meier analysis was used to calculate the 5-year survival rate. Log-minus-log transformation was performed to calculate the 95% confidence interval (95%CI). Mixed model analyses were performed to assess the course of the PROMs during the 1st 2 years after surgery. Analyses were modeled separately for the 1st and 2nd years to calculate the yearly change in PROMs during both follow-up periods with accompanying 95%CIs. RESULTS The mean age of the total 500 patients was 62.3 years (standard deviation: 10.6) and 202 were male (40%). At a median follow-up of 5.5 years (interquartile range: 4.5-6.7), 7 patients were deceased and 6 revisions were registered, for infection (n = 3), subsidence (n = 2) and malposition (n = 1). This resulted in an overall 5-year survival of 98.8% (95%CI: 97.3-99.5). If infection was left out as reason for revision, a stem survival of 99.4% (95%CI: 98.1-99.8) was seen. Baseline questionnaires were completed by 471 patients (94%), 317 patients (63%) completed the 1-year follow-up questionnaires and 233 patients (47%) completed the 2-year follow-up. Both outcome measures significantly improved across all domains in the 1st year after the operation (P < 0.03 for all domains). In the 2nd year after surgery, no significant changes were observed in any domain in comparison to the 1-year follow-up. CONCLUSION The Optimys stem has a 5-year survival of 98.8%. Patient-reported outcome measures increased significantly in the 1st postoperative year with stabilization at the 2-year follow-up.

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Calcar-guided short-stem total hip arthroplasty in fractures of the femoral neck: a prospective observational study of 68 hips

Kutzner,

Walz,

Afghanyar

et al. 2024

Arch Orthop Trauma Surg

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Survivorship, complications and patient-reported outcomes in calcar-guided short-stem THA: prospective mid-term multicenter data of the first 879 hips

Cited by 4 publications

References 24 publications

Subsidence rate and long-term outcome of a calcar-guided short stem: A prospective 10-year follow-up study

Subsidence rate and long-term outcome of a calcar-guided short stem: A prospective 10-year follow-up study

Mid-term survival of the Optimys short stem: A prospective case series of 500 patients

Calcar-guided short-stem total hip arthroplasty in fractures of the femoral neck: a prospective observational study of 68 hips

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