François Fauré, Cécile Batailler, Constant Foissey, Elvire Servien, Sébastien Lustig
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Femoral stem positioning was measured.</p><p><strong>Results: </strong>The mean follow-up was 12 ± 0.5 months. The mean age was 64.1 ± 11.7 years. The mean BMI was 26.4 ± 4.4 kg/m<sup>2</sup>. Shortened stems showed a significantly lower rate of femoral complications (1.4% vs. 5.5%, P = 0.005), particularly for the GT fractures (P = 0.006). In the shortened group, stem alignment was neutral in 69% of cases, varus in 27%, and valgus in 4%.</p><p><strong>Conclusion: </strong>Shortened stems in DAA THA were associated with a lower rate of femoral complications, particularly fewer GT fractures. Although shortened stems were more often positioned in varus, this did not impact short-term complication rates.</p><p><strong>Trial registration: </strong>The Advisory Committee on Research Information Processing in the Field of Health (CCTIRS) approved this study on June 4, 2015 (Study ID 15-430). 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引用次数: 0
摘要
导读：在全髋关节置换术（THA）中，通过直接前路（DAA）选择股骨干设计是至关重要的。短茎提供了潜在的好处，如骨骼保护和减少应力屏蔽。本研究旨在比较缩短和标准的DAA THA术后1年的早期并发症。方法：回顾性单中心病例对照研究纳入2013年至2023年接受DAA THA手术的患者。对两个队列进行了分析：537例标准柄全髋关节置换术和346例短柄全髋关节置换术。每组343名患者根据年龄、性别和身体质量指数（BMI）进行1:1匹配。两名独立观察员在一年内评估股骨并发症。测量股干定位。结果：平均随访12±0.5个月。平均年龄64.1±11.7岁。平均BMI为26.4±4.4 kg/m2。短柄的股骨并发症发生率明显较低（1.4% vs. 5.5%, P = 0.005），尤其是GT骨折（P = 0.006）。在缩短的组中，69%的病例是中性的，27%的病例是内翻，4%的病例是外翻。结论：短柄DAA THA股骨并发症发生率较低，尤其是GT骨折发生率较低。虽然短柄更常定位于内翻，但这并不影响短期并发症的发生率。试验注册：卫生领域研究信息处理咨询委员会（CCTIRS）于2015年6月4日批准了这项研究（研究ID 15-430）。视频摘要。
Does the use of shortened stems reduce early femoral complications in total hip arthroplasty using the direct anterior approach?
Introduction: The choice of femoral stem design during total hip arthroplasty (THA) through the Direct Anterior Approach (DAA) is critical. Shortened stems offer potential benefits such as bone preservation and reduced stress shielding. This study aimed to compare early complications at one year of follow-up between shortened and standard stems in DAA THA.
Methods: A retrospective monocentric case-control study included patients undergoing DAA THA from 2013 to 2023. Two cohorts were analyzed: 537 THA with standard stems and 346 THA with shortened stems. Three hundred forty-three patients in each group were matched (1:1) based on age, sex, and Body Mass Index (BMI). Two independent observers assessed femoral complications at one year. Femoral stem positioning was measured.
Results: The mean follow-up was 12 ± 0.5 months. The mean age was 64.1 ± 11.7 years. The mean BMI was 26.4 ± 4.4 kg/m2. Shortened stems showed a significantly lower rate of femoral complications (1.4% vs. 5.5%, P = 0.005), particularly for the GT fractures (P = 0.006). In the shortened group, stem alignment was neutral in 69% of cases, varus in 27%, and valgus in 4%.
Conclusion: Shortened stems in DAA THA were associated with a lower rate of femoral complications, particularly fewer GT fractures. Although shortened stems were more often positioned in varus, this did not impact short-term complication rates.
Trial registration: The Advisory Committee on Research Information Processing in the Field of Health (CCTIRS) approved this study on June 4, 2015 (Study ID 15-430). Video Abstract.
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