Sébastien Daudi, Vasileios Zampelis, Ola Belfrage, Gunnar Flivik
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Patients were followed for ten years with repeated RSA and DXA examinations. Patient-reported outcome measures (PROMs), Hip disability and Osteoarthritis Outcome Score, EuroQol five-dimension questionnaire, and Forgotten Joint Score were collected.</p><p><strong>Results: </strong>A total of 45 patients remained at the ten-year follow-up. RSA showed early implant stabilization and osseointegration within three months after an initial subsidence of 0.62 mm (95% CI 0.33 to 0.91) for collared and 0.76 mm (95% CI 0.55 to 0.96) for collarless stems. Minimal further migration was observed up to ten years. Net bone mineral density at ten years was -3.3% (95% CI -9.2 to 2.7) and -2% (95% CI -7.3 to 3.4) in collared and collarless stems, respectively. The presence of a collar did not result in any statistically significant differences either for RSA or DXA results. PROMs improved as expected, and remained high up to ten years in both groups. None of the stems was revised.</p><p><strong>Conclusion: </strong>The short stem remains stable at ten years and preserves bone mass, both with and without a collar. These findings support the continued use and further evaluation of this type of short, uncemented stem.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 9","pages":"865-872"},"PeriodicalIF":4.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stem migration and bone density at ten years : a randomized radiostereometry and dual-energy X-ray absorptiometry study on a short uncemented hip stem with and without a collar.\",\"authors\":\"Sébastien Daudi, Vasileios Zampelis, Ola Belfrage, Gunnar Flivik\",\"doi\":\"10.1302/0301-620X.107B9.BJJ-2024-1720.R1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Short, uncemented hip stems might provide a favourable alternative in total hip arthroplasty (THA) by preserving proximal bone mass through reduced strain-adaptive remodelling. We evaluated and compared the migration and periprosthetic bone remodelling of a short stem with and without a collar, using radiostereometric analysis (RSA) to measure implant migration and dual-energy X-ray absorptiometry (DXA) to evaluate periprosthetic bone remodelling. In this study we present ten-year follow-up results, completing previously published two- and five-year RSA and DXA studies.</p><p><strong>Methods: </strong>A total of 50 patients (34 males) underwent THA due to osteoarthritis and were randomized to either a collared or collarless short stem. Patients were followed for ten years with repeated RSA and DXA examinations. Patient-reported outcome measures (PROMs), Hip disability and Osteoarthritis Outcome Score, EuroQol five-dimension questionnaire, and Forgotten Joint Score were collected.</p><p><strong>Results: </strong>A total of 45 patients remained at the ten-year follow-up. RSA showed early implant stabilization and osseointegration within three months after an initial subsidence of 0.62 mm (95% CI 0.33 to 0.91) for collared and 0.76 mm (95% CI 0.55 to 0.96) for collarless stems. Minimal further migration was observed up to ten years. Net bone mineral density at ten years was -3.3% (95% CI -9.2 to 2.7) and -2% (95% CI -7.3 to 3.4) in collared and collarless stems, respectively. The presence of a collar did not result in any statistically significant differences either for RSA or DXA results. PROMs improved as expected, and remained high up to ten years in both groups. None of the stems was revised.</p><p><strong>Conclusion: </strong>The short stem remains stable at ten years and preserves bone mass, both with and without a collar. These findings support the continued use and further evaluation of this type of short, uncemented stem.</p>\",\"PeriodicalId\":48944,\"journal\":{\"name\":\"Bone & Joint Journal\",\"volume\":\"107-B 9\",\"pages\":\"865-872\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bone & Joint Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1302/0301-620X.107B9.BJJ-2024-1720.R1\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/0301-620X.107B9.BJJ-2024-1720.R1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：短的、未骨水泥的髋关节干可以通过减少应变适应性重构来保存近端骨量，从而为全髋关节置换术（THA）提供一个有利的选择。我们使用放射立体分析（RSA）测量种植体迁移和双能x射线吸收测量（DXA）评估假体周围骨重塑，评估并比较了带和不带假体环的短茎的迁移和假体周围骨重塑。在这项研究中，我们提出了十年的随访结果，完成了先前发表的两年和五年的RSA和DXA研究。方法：共有50例患者（34名男性）因骨关节炎接受了THA，随机分为有领或无领短茎。随访10年，反复进行RSA和DXA检查。收集患者报告的预后指标（PROMs）、髋关节残疾和骨关节炎预后评分、EuroQol五维问卷和遗忘关节评分。结果：随访10年，共有45例患者存活。RSA显示，有环的种植体在初始下沉0.62 mm （95% CI 0.33 ~ 0.91）和无环的种植体在初始下沉0.76 mm （95% CI 0.55 ~ 0.96）后3个月内早期种植体稳定和骨整合。十年之内观察到的进一步迁移极小。10年时，有项圈和无项圈的净骨矿物质密度分别为-3.3% （95% CI -9.2至2.7）和-2% （95% CI -7.3至3.4）。对于RSA或DXA结果来说，项圈的存在并没有导致任何统计学上的显著差异。正如预期的那样，两组的prom都有所提高，并且在10年内都保持在较高水平。所有的茎都没有被修改。结论：不论有无骨环，短骨柄均能保持稳定，保留骨量。这些研究结果支持继续使用和进一步评估这种短的、未胶结的管柱。
Stem migration and bone density at ten years : a randomized radiostereometry and dual-energy X-ray absorptiometry study on a short uncemented hip stem with and without a collar.
Aims: Short, uncemented hip stems might provide a favourable alternative in total hip arthroplasty (THA) by preserving proximal bone mass through reduced strain-adaptive remodelling. We evaluated and compared the migration and periprosthetic bone remodelling of a short stem with and without a collar, using radiostereometric analysis (RSA) to measure implant migration and dual-energy X-ray absorptiometry (DXA) to evaluate periprosthetic bone remodelling. In this study we present ten-year follow-up results, completing previously published two- and five-year RSA and DXA studies.
Methods: A total of 50 patients (34 males) underwent THA due to osteoarthritis and were randomized to either a collared or collarless short stem. Patients were followed for ten years with repeated RSA and DXA examinations. Patient-reported outcome measures (PROMs), Hip disability and Osteoarthritis Outcome Score, EuroQol five-dimension questionnaire, and Forgotten Joint Score were collected.
Results: A total of 45 patients remained at the ten-year follow-up. RSA showed early implant stabilization and osseointegration within three months after an initial subsidence of 0.62 mm (95% CI 0.33 to 0.91) for collared and 0.76 mm (95% CI 0.55 to 0.96) for collarless stems. Minimal further migration was observed up to ten years. Net bone mineral density at ten years was -3.3% (95% CI -9.2 to 2.7) and -2% (95% CI -7.3 to 3.4) in collared and collarless stems, respectively. The presence of a collar did not result in any statistically significant differences either for RSA or DXA results. PROMs improved as expected, and remained high up to ten years in both groups. None of the stems was revised.
Conclusion: The short stem remains stable at ten years and preserves bone mass, both with and without a collar. These findings support the continued use and further evaluation of this type of short, uncemented stem.
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