Mid-Term Outcomes of a Short Modular Neck-Preserving Cementless Hip Stem: A Retrospective Study With a 6-Year Minimum Follow-Up

Michele Carnovale, MD; Daniele De Meo, MD; Giovanni Guarascio, MD; Paolo Martini, MD; Gianluca Cera, MD; Pietro Persiani, MD, PhD; Vittorio Candela, MD; Stefano Gumina, MD, PhD; Ciro Villani, MD

Arthroplasty Today (Jun 2024)

Mid-Term Outcomes of a Short Modular Neck-Preserving Cementless Hip Stem: A Retrospective Study With a 6-Year Minimum Follow-Up

Michele Carnovale, MD,
Daniele De Meo, MD,
Giovanni Guarascio, MD,
Paolo Martini, MD,
Gianluca Cera, MD,
Pietro Persiani, MD, PhD,
Vittorio Candela, MD,
Stefano Gumina, MD, PhD,
Ciro Villani, MD

Affiliations

Michele Carnovale, MD: Emergency Department, Policlinico Umberto I University Hospital, Rome, Italy
Daniele De Meo, MD: Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Department of General Surgery, Plastic Surgery and Orthopaedics, Policlinico Umberto I University Hospital, Rome, Italy; Corresponding author. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Piazzale Aldo Moro, 3, Rome 00161, Italy. Tel.: +39 333 874 5373.
Giovanni Guarascio, MD: Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Department of General Surgery, Plastic Surgery and Orthopaedics, Policlinico Umberto I University Hospital, Rome, Italy
Paolo Martini, MD: Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Department of General Surgery, Plastic Surgery and Orthopaedics, Policlinico Umberto I University Hospital, Rome, Italy
Gianluca Cera, MD: Emergency Department, Policlinico Umberto I University Hospital, Rome, Italy
Pietro Persiani, MD, PhD: Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Department of General Surgery, Plastic Surgery and Orthopaedics, Policlinico Umberto I University Hospital, Rome, Italy
Vittorio Candela, MD: Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Department of General Surgery, Plastic Surgery and Orthopaedics, Policlinico Umberto I University Hospital, Rome, Italy
Stefano Gumina, MD, PhD: Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Istituto Clinico Ortopedico Traumatologico (ICOT), Latina, Italy
Ciro Villani, MD: Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy; Department of General Surgery, Plastic Surgery and Orthopaedics, Policlinico Umberto I University Hospital, Rome, Italy

Journal volume & issue: Vol. 27
p. 101387

Abstract

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Background: The neck-preserving cementless short stem represents a valid therapeutic option for total hip replacement in high-functional-demand patients, but few studies are available about the use of modularity in the last-generation short stem. The aim of the study was to evaluate the mid-term survival of a specific implant design that combines partial collum short hip stem with neck modularity; assessing the functional status was the second endpoint. Methods: A retrospective single-center cohort study was conducted on 75 patients aged 35 to 80 years, with a minimum 6-year follow-up. Patients with neurological/rheumatic pathologies and previous hip surgeries were excluded. All the patients underwent total hip replacement with a short modular neck-preserving cementless hip stem. Clinical outcomes, complications, revisions, and the Western Ontario and McMaster Universities Osteoarthritis Index, Harris hip score, and Short Form 12-Item Health Survey (SF-12) questionnaires were evaluated. The results were compared with healthy population’s data extracted from the literature, stratified by age. Results: The Kaplan-Meier analysis revealed a 10-year implant survival rate of 96.7%, coupled with a revision rate of 1.3%. Results showed a Harris hip score and physical SF-12 significantly lower and a mental SF-12 higher when compared to healthy population. No statistically significant differences emerged when comparing groups based on neck modularity. Conclusions: The short modular neck-preserving cementless hip stem emerged as a reasonable choice for patients with elevated functional demands, ensuring good clinical outcomes while preserving bone integrity. The use of a modular neck in short stems didn’t show any mechanical problems in the mid-term.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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