Mid-Term to Long-Term Outcomes of Total Hip Arthroplasty Using a Cementless Trochanteric Sparing Short Stem Through Direct Anterior Approach: A Single-Center Study

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-02-07 DOI:10.1016/j.artd.2025.101623

Seyed Mohammad Javad Mortazavi MD , Pouya Tabatabaei Irani MD , Mohammad Poursalehian MD , Mahsa Mahanrad MD, Peyman Mirghaderi MD, Mohammadreza Razzaghof MD, Sadegh Saberi MD

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引用次数: 0

Abstract

Background

Total hip arthroplasty (THA) is increasingly performed in younger patients, necessitating long-term femoral bone preservation. Metaphyseal engaging short stems offer potential benefits by reducing stress shielding and preserving bone stock. However, lacking long-term data in large quantities and younger patients in the literature led this study to assess mid-term to long-term outcome of these short stems.

Methods

This retrospective study evaluated the long-term outcomes of 755 hips (667 patients) underwent THA using the Fitmore stem via a direct anterior approach. Clinical and radiographic assessments were conducted, and survival rates were determined using Kaplan-Meier analyses. Statistical analyses were performed to identify associations and predictors of stem revision.

Results

The overall survival rate for the Fitmore stem was 92.11% at an average follow-up of 10 years. No revisions were performed due to aseptic loosening of the femoral component. Stem revisions were performed in 20 hips, primarily due to periprosthetic fractures followed by periprosthetic joint infections and recurrent dislocations. The clinical outcomes showed significant improvements in HHS, WOMAC Index, and VAS pain scores. Radiographic analysis revealed acceptable rates of complications, with minimal stem subsidence, no severe bone loss, and a low incidence of radiolucent lines and cortical hypertrophy.

Conclusions

The Fitmore stem demonstrated favorable mid-term to long-term outcomes in terms of implant survival, functional scores, and radiographic assessments even in younger populations. The findings contribute to the existing body of knowledge on the Fitmore stem’s efficacy and safety in preserving bone and achieving satisfactory clinical outcomes in THA.

Level of evidence

IV.

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.