Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL.
Southwestern Vermont Health Care, Bennington, VT.
J Arthroplasty. 2022 Aug;37(8):1606-1611. doi: 10.1016/j.arth.2022.03.080. Epub 2022 Apr 1.
Short-stem femoral implants (SSFIs) promote the preservation of bone in the femoral neck, reduce soft tissue disruption, and facilitate minimally invasive surgical techniques. The purpose of this study was to report the revision rate, complication rate, patient satisfaction, patient-reported outcomes, and radiographic outcomes of patients who underwent total hip arthroplasty (THA) with the Alteon Neck Preserving Femoral Stem (ANPS).
A prospectively maintained database was reviewed which analyzed 92 THAs between the years 2016 and 2018. Patient-reported outcomes, patient satisfaction, complication rates, and radiographic outcomes were assessed at 2-5 years postoperatively.
The final cohort consisted of 63 hips. Five patients (7.9%) underwent revision surgery and 2 (3.2%) had other complications not requiring revision. Survivorship when considering only the femoral component was 93.7% at an average of 41.4 months of follow-up. The average postoperative Oxford Hip Score (41.5 ± 8.3) and Harris Hip Score (77.9 ± 16.6) demonstrated significant improvement among our nonrevised patients, respectively (P < .001). Radiographs demonstrated spot welding in 56% of arthroplasties most commonly in Gruen Zones 2, 3, and 13 and that femur radiolucencies were visualized in 58% predominantly along the distal aspect of the stem. Radiographic femoral component subsidence was present in 9.7% of patients.
The ANPS may be less reliable than previously reported. Our cohort's revision rate was unacceptably high with 6.3% requiring revision surgery for femoral component loosening in less than 5 years. Surgeons should consider the challenges and prohibitive failure rate associated with SSFIs before routine usage in THA.
短柄股骨假体（SSFI）促进股骨颈骨的保留，减少软组织破坏，并有利于微创外科技术。本研究的目的是报告使用 Alteon Neck Preserving Femoral Stem（ANPS）进行全髋关节置换术（THA）的患者的翻修率、并发症率、患者满意度、患者报告的结果和影像学结果。
对 2016 年至 2018 年期间进行的 92 例 THA 进行了前瞻性维护数据库回顾分析。术后 2-5 年评估患者报告的结果、患者满意度、并发症发生率和影像学结果。
最终队列包括 63 髋。5 例（7.9%）患者行翻修手术，2 例（3.2%）患者有其他无需翻修的并发症。考虑股骨部件时，平均随访 41.4 个月时的生存率为 93.7%。非翻修患者的平均术后牛津髋关节评分（41.5±8.3）和 Harris 髋关节评分（77.9±16.6）分别显著改善（P<.001）。X 线片显示 56%的关节置换物有点焊，最常见于 Gruen 区 2、3 和 13，58%的患者在股骨假体远端可见股骨透亮线。9.7%的患者存在股骨假体下沉。
ANPS 的可靠性可能不如先前报道的。我们的队列中翻修率很高，6.3%的患者在不到 5 年内因股骨部件松动需要翻修手术。在常规使用 THA 之前，外科医生应考虑到 SSFI 带来的挑战和高失败率。
