See the published version of this preprint at Journal of Orthopaedic Surgery and Research.
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Research article
Julian Hasler
Balgrist University Hospital: Universitatsklinik Balgrist
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8237-1611
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: There has been an evolution in cementless total hip arthroplasty (THA) with newer short stem designs aim to preserve metaphyseal bone stock and facilitate implantation through minimally invasive approaches. While early subsidence has been correlated to aseptic loosening in conventional stems, there is a paucity of data regarding short stems. The current study aims to report on stem subsidence and midterm clinical outcomes of a cementless, metaphyseal-anchored short femoral stem, specifically designed for the direct anterior approach (DAA).
Methods: 94 consecutive patients (100 hips) with a minimum follow-up of 5 years following cementless THA were included in this single-center retrospective study. Subsidence was evaluated using the “Ein-Bild-Roentgen-Analyse” (EBRA). Periprosthetic radiolucency allocated to the Zones of Charnley and Gruen was assessed. Additionally, demographic and implant-related factors potentially associated with increased subsidence and clinical outcomes were evaluated.
Results: At the last follow-up, the average stem subsidence was 1.98 ± 1.20 mm, with 48% of the implants demonstrating subsidence of > 2 mm. Periprosthetic radiolucency of > 2 mm was found in 26% of the implants in Zone 1, and in 9% in Zone 7, respectively. Neither the amount of subsidence nor proximal periprosthetic radiolucency was associated with aseptic loosening or worse clinical outcomes.
Conclusions: Comparable to other proximally-fixed short stem designs, the highest subsidence was observed within the first 3 months following implantation. No demographic or implant-related factors were found to have a statistically significant influence on stem subsidence. Periprosthetic radiolucency and subsidence of the AMISstem is not correlated with worse clinical outcomes at 5-years follow-up.
Keywords
Subsidence, Total Hip Arthroplasty, cementless, metaphyseal-anchored femoral stem, EBRA
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View the published article at Journal of Orthopaedic Surgery and Research.
Version 1
Posted 09 Oct, 2020
No community comments so far
Review #2 received
Received 18 Oct, 2020
Editorial decision: Minor revision
On 18 Oct, 2020
Review #1 received
Received 17 Oct, 2020
Reviewer #3 agreed
On 10 Oct, 2020
Reviewer #2 agreed
On 08 Oct, 2020
Reviewers invited
Invitations sent on 07 Oct, 2020
Reviewer #1 agreed
On 07 Oct, 2020
Editor assigned
On 05 Oct, 2020
First submitted
On 04 Oct, 2020
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On 04 Oct, 2020
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A new preprint design is coming!
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See the published version of this preprint at Journal of Orthopaedic Surgery and Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Julian Hasler
Balgrist University Hospital: Universitatsklinik Balgrist
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8237-1611
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Journal of Orthopaedic Surgery and Research.
Version 1
Posted 09 Oct, 2020
No community comments so far
Review #2 received
Received 18 Oct, 2020
Editorial decision: Minor revision
On 18 Oct, 2020
Review #1 received
Received 17 Oct, 2020
Reviewer #3 agreed
On 10 Oct, 2020
Reviewer #2 agreed
On 08 Oct, 2020
Reviewers invited
Invitations sent on 07 Oct, 2020
Reviewer #1 agreed
On 07 Oct, 2020
Editor assigned
On 05 Oct, 2020
First submitted
On 04 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Journal of Orthopaedic Surgery and Research.
Background: There has been an evolution in cementless total hip arthroplasty (THA) with newer short stem designs aim to preserve metaphyseal bone stock and facilitate implantation through minimally invasive approaches. While early subsidence has been correlated to aseptic loosening in conventional stems, there is a paucity of data regarding short stems. The current study aims to report on stem subsidence and midterm clinical outcomes of a cementless, metaphyseal-anchored short femoral stem, specifically designed for the direct anterior approach (DAA).
Methods: 94 consecutive patients (100 hips) with a minimum follow-up of 5 years following cementless THA were included in this single-center retrospective study. Subsidence was evaluated using the “Ein-Bild-Roentgen-Analyse” (EBRA). Periprosthetic radiolucency allocated to the Zones of Charnley and Gruen was assessed. Additionally, demographic and implant-related factors potentially associated with increased subsidence and clinical outcomes were evaluated.
Results: At the last follow-up, the average stem subsidence was 1.98 ± 1.20 mm, with 48% of the implants demonstrating subsidence of > 2 mm. Periprosthetic radiolucency of > 2 mm was found in 26% of the implants in Zone 1, and in 9% in Zone 7, respectively. Neither the amount of subsidence nor proximal periprosthetic radiolucency was associated with aseptic loosening or worse clinical outcomes.
Conclusions: Comparable to other proximally-fixed short stem designs, the highest subsidence was observed within the first 3 months following implantation. No demographic or implant-related factors were found to have a statistically significant influence on stem subsidence. Periprosthetic radiolucency and subsidence of the AMISstem is not correlated with worse clinical outcomes at 5-years follow-up.
Figure 1
Figure 2
Figure 3
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