Suksathien Yingyong, Suarjui Jithayut, Tippimanchai Thanut, Suksathien Rachawan, Lajuntuk Bankchart, Khamphaeng Sirawitz
Department of Orthopaedic Surgery, Maharat Nakhon Ratchasima Hospital, Chang Phueak Rd, Mueang District, Nakhon Ratchasima Province, Ratchasima Province, 30000, Thailand.
Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Chang Phueak Rd, Muang District, Nakhon, Ratchasima Province, 30000, Thailand.
Arch Orthop Trauma Surg. 2024 Dec 12;145(1):9. doi: 10.1007/s00402-024-05680-0.
Short stem total hip arthroplasty (THA) is an alternative to conventional stem, designed to facilitate minimal-invasive surgery, physiological loading and preserve bone stock. However, there is insufficient evidence of the long-term outcomes in patients with osteonecrosis of the femoral head (ONFH). This study aims to analyze the clinical and radiographic results with a minimum follow-up of 10 years. Furthermore, the survival rate of the short stem was calculated.
There were 81 patients (101 hips) with the mean age of 45 years (range, 21 to 68) in this study. The Harris Hip Scores (HHS) and Forgotten Joint Scores (FJS) were recorded to evaluate the clinical results. The appearance of osteointegration and radiolucent line were reviewed. The mean follow-up period was 129.3 months (range, 120-154).
At the latest follow-up, the mean HHS and FJS were 96.9 ± 5.7 (range, 69-100) and 95 ± 7 (range, 75-100) points respectively. The radiographic changes around the stem showed osteointegration mainly in the proximal part, zones 1 (94.1%), 2 (84.2%), 6 (99%) and 7 (92.1%). One stem underwent revision due to periprosthetic fracture, using conventional stem with plate and screws. Survivorship of the stem with the endpoint for any reason was 99.01% (95% confidence interval [CI], 93.18-99.86%) and for aseptic loosening was 100% at 10 years.
Short stem showed promising long-term clinical outcomes in patients with ONFH. The radiographic results demonstrated physiological proximal load transfer.
短柄全髋关节置换术（THA）是传统柄的一种替代方案，旨在便于进行微创手术、实现生理负荷并保留骨量。然而，对于股骨头坏死（ONFH）患者的长期疗效，证据尚不充分。本研究旨在分析至少随访10年的临床和影像学结果。此外，还计算了短柄的生存率。
本研究纳入81例患者（101髋），平均年龄45岁（范围21至68岁）。记录Harris髋关节评分（HHS）和遗忘关节评分（FJS）以评估临床结果。复查骨整合和透亮线的情况。平均随访时间为129.3个月（范围120 - 154个月）。
在最近一次随访时，平均HHS和FJS分别为96.9±5.7（范围69 - 100）和95±7（范围75 - 100）分。柄周围的影像学改变显示骨整合主要在近端部分，即1区（94.1%）、2区（84.2%）、6区（99%）和7区（92.1%）。1例柄因假体周围骨折接受翻修，使用带钢板和螺钉的传统柄。柄因任何原因的10年生存率为99.01%（95%置信区间[CI]，93.18 - 99.86%），无菌性松动的10年生存率为100%。
短柄在ONFH患者中显示出良好的长期临床疗效。影像学结果表明近端实现了生理负荷传递。
