Department of Orthopedics and Traumatology, University Hospital Basel, 4031 Basel, Switzerland.
Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland.
Medicina (Kaunas). 2023 Oct 13;59(10):1822. doi: 10.3390/medicina59101822.
: Implantation of a short femoral stem in revision total hip arthroplasty (rTHA) could reduce the perioperative time, soft tissue damage, and preserve the bone stock of the proximal femur. The objective of this study was to describe the clinical and radiographic outcomes after the use of short stems in rTHA with a follow-up of 1 to 5 years. : This retrospective, single center, and observational study analyzed the data of 31 patients (12 female, 19 male) with a median (interquartile range) age of 68.2 years (61.2-78.4) and BMI of 26.7 kg/m (24.6-29.4) who received an uncemented short femoral stem in rTHA between 2015 and 2020. Clinical outcomes were extracted from medical reports and assessed using the modified Harris Hip Score (mHHS), the numerical rating scale (NRS) for pain and satisfaction, and the UCLA Physical Activity Score. Radiographs were analyzed for stem subsidence, fixation, and bone parameters. The Wilcoxon test was used for pre-post rTHA differences ( < 0.05); clinical relevance was interpreted based on effect sizes according to Cohen's . : All the clinical outcome measures improved significantly ( ≤ 0.001) at follow-up compared to preoperative status, with large effect sizes (Cohen's ) ranging from 2.8 to 1.7. At the last follow-up, the median (interquartile) mHHS was 80.9 (58.6-93.5). Stem fixation was stable in all cases. Complications included stem subsidence of 3 mm (n = 1) and 10 mm (n = 1), heterotopic ossification Brooker stage III (n = 2), intraoperative femur perforation (n = 1), periprosthetic fracture Vancouver type A (n = 1), and dislocation (n = 2). : The good clinical results in our selective study population of patients with mild to moderate bone deficiency, supported by large effect sizes, together with a complication rate within the normal range, support the consideration of short stems as a surgical option after a thorough preoperative analysis.
: 在翻修全髋关节置换术（rTHA）中植入短股骨柄可以减少围手术期时间、软组织损伤，并保留股骨近端的骨量。本研究的目的是描述在 rTHA 中使用短柄后的临床和影像学结果，随访时间为 1 至 5 年。 : 这是一项回顾性、单中心、观察性研究，分析了 2015 年至 2020 年间接受 rTHA 中使用非骨水泥短股骨柄的 31 名患者（12 名女性，19 名男性）的临床数据，这些患者的中位（四分位间距）年龄为 68.2 岁（61.2-78.4），BMI 为 26.7kg/m（24.6-29.4）。临床结果从病历中提取，并使用改良 Harris 髋关节评分（mHHS）、疼痛和满意度的数字评分量表（NRS）以及 UCLA 身体活动评分进行评估。对射线照片进行分析，以评估柄的下沉、固定和骨参数。Wilcoxon 检验用于 rTHA 前后的差异（<0.05）；根据 Cohen's ，临床相关性基于效应大小进行解释。 : 在随访时，所有临床结果测量都比术前显著改善（≤0.001），具有较大的效应大小（Cohen's ）范围为 2.8 至 1.7。在最后一次随访时，mHHS 的中位数（四分位距）为 80.9（58.6-93.5）。所有情况下的柄固定均稳定。并发症包括 3 毫米（n=1）和 10 毫米（n=1）的柄下沉、Brooker Ⅲ级异位骨化（n=2）、术中股骨穿孔（n=1）、假体周围骨折 Vancouver A 型（n=1）和脱位（n=2）。 : 在我们的选择性患者人群中，具有轻度至中度骨量不足的患者，具有较大的效应大小，同时并发症发生率处于正常范围内，这支持在进行彻底的术前分析后，将短柄作为一种手术选择。
