Uncemented cervico-metaphyseal short stems in selected proximal femoral deformities: long-term outcomes without adjunctive osteotomy.

Abstract

Background: Proximal femoral deformities (PFDs) pose a challenge due to complex anatomical alterations that often require demanding procedures with suboptimal outcomes. We hypothesised that uncemented short stems allow reconstruction without adjunctive osteotomies. This study aimed to evaluate long-term implant survivorship, clinical outcomes, and complication rates in patients with PFDs treated using an uncemented short stem.

Methods: We retrospectively reviewed 35 hips in 31 patients with PFDs who underwent total hip arthroplasty between 2011 and 2018. Mean age was 44 years, and median follow-up was 131 months. We analysed whether an additional osteotomy was required, and assessed leg-length discrepancy (LLD) and femoral offset before and after surgery. Functional outcomes were measured using visual analogue scale (VAS) and the modified Harris Hip Score (mHHS). Implant survival and all complications were documented.

Results: No patient required an additional femoral osteotomy. Both LLD and femoral offset improved significantly (p < 0.001). VAS and mHHS improved at last follow-up. 5 complications (14%) were recorded, with a stem survival rate of 97.1%.

Conclusions: In carefully selected patients with proximal femoral deformities, uncemented cervico-metaphyseal short stems demonstrated durable long-term outcomes without the need for adjunctive femoral osteotomy in this series.