Department of Orthopedic Surgery , Orthopedic Research Center Amsterdam , Academic Medical Center.
Acta Orthop. 2014 Jun;85(3):250-8. doi: 10.3109/17453674.2014.908343. Epub 2014 Apr 3.
The aim of short-stem total hip arthroplasty is to preserve proximal bone stock for future revisions, to improve biomechanical reconstruction, and to make minimally invasive approaches easier. It is therefore being increasingly considered to be a sound alternative to conventional total hip arthroplasty, especially for young and active patients. However, it is still unknown whether survival rates of short-stem hips match current standards. We made a systematic summary of reported overall survival after short-stem total hip arthroplasty.
We conducted a systematic review of English, French, German, and Dutch literature. 2 assessors independently identified clinical studies on short-stem hip arthroplasty. After recalculating reported revision rates, we determined whether each implant had a projected revision rate of 10% or less at 10 years of follow-up or a revision rate per 100 observed component years of 1 or less. Stems were classified as "collum", "partial collum", or "trochanter-sparing".
We found 49 studies, or 51 cohorts, involving 19 different stems. There was a large increase in recent publications. The majority of studies included had a follow-up of less than 5 years. We found a large number of observational studies on "partial collum" and "trochanter-sparing" stems, demonstrating adequate survival rates at medium-term follow-up. Clinical evidence from "collum stem" studies was limited to a small number of studies with a medium-term follow-up period. These studies did not show a satisfactory overall survival rate.
短柄全髋关节置换术的目的是为了保留股骨近端骨量以备将来翻修，改善生物力学重建，并使微创入路更容易。因此，它越来越被认为是传统全髋关节置换术的一种合理替代方法，尤其是对于年轻和活跃的患者。然而，短柄髋关节的生存率是否能达到目前的标准仍不清楚。我们对短柄全髋关节置换术后的总体生存率进行了系统总结。
我们对英语、法语、德语和荷兰语文献进行了系统回顾。2 名评估员独立确定了关于短柄髋关节置换术的临床研究。在重新计算报告的翻修率后，我们确定每个植入物在 10 年随访时是否有 10%或更低的预计翻修率，或者在 100 个观察到的组件年中是否有 1 个或更少的翻修率。柄被分为“股骨颈”、“部分股骨颈”或“转子下保留”。
我们发现了 49 项研究，或 51 个队列，涉及 19 种不同的柄。最近的出版物数量有了很大的增加。大多数研究的随访时间都不到 5 年。我们发现了大量关于“部分股骨颈”和“转子下保留”柄的观察性研究，这些研究在中期随访中显示出了足够的生存率。来自“股骨颈柄”研究的临床证据仅限于少数具有中期随访的研究。这些研究并没有显示出令人满意的总体生存率。
