Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2025; 16(1): 100173
Published online Jan 18, 2025. doi: 10.5312/wjo.v16.i1.100173
Long-term follow-up result of short metaphyseal femoral stem in primary total hip arthroplasty: A retrospective study
Manoj Kumar, Ayush Sharma, Vivek P Ksheerasagar, Akash K Ghosh, Mukund Lal
Manoj Kumar, Ayush Sharma, Mukund Lal, Department of Orthopaedics, Indira Gandhi Medical College and Hospital, Shimla 171001, Himāchal Pradesh, India
Vivek P Ksheerasagar, Akash K Ghosh, Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, Chandīgarh, India
Author contributions: Kumar M, Sharma A, and Ksheerasagar VP designed the research study, performed the research and collected the data; Ksheerasagar VP, Ghosh AK, and Lal M analyzed the data and wrote the manuscript; and all authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India. The performance of the study was conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki (IRB-2257).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Participants gave informed consent for anonymized data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vivek P Ksheerasagar, Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, Chandīgarh, India. vivekpk574@gmail.com
Received: August 8, 2024
Revised: September 23, 2024
Accepted: November 12, 2024
Published online: January 18, 2025
Processing time: 157 Days and 14.3 Hours
Abstract
BACKGROUND

Total hip arthroplasty (THA) has increased along with an increasing demand for improved quality of life. Combined with prolonged life expectancy, the number of revision surgeries is expected to increase. Stress shielding is a significant issue with traditional femoral stems used in THA, making revision surgeries particularly challenging in younger patients. This has sparked renewed interest in studying safety and functional outcomes of short metaphyseal femoral stems, which have the potential to alleviate these challenges and simplify revision surgeries.

AIM

To evaluate the long-term outcomes of short-stem THA.

METHODS

A total of 124 hips that underwent THA using the short femoral stem (TRILOCK® Depuy) between May 2006 and November 2008 were included in this study. Patients were followed for a period of 15 years. Outcomes were assessed in terms of pain relief, hip joint range of motion, improvement in mobility, and functional outcomes using the modified Harris Hip Score, Oxford hip score, and Western Ontario and McMaster Universities Osteoarthritis index score.

RESULTS

A total of 124 hips in 98 patients were evaluated. Significant improvements in functional outcomes were observed over the 15-year follow-up period, with no cases of subsidence, implant loosening, or complications necessitating revision surgery. The only complication reported was heterotopic ossification in 1 patient.

CONCLUSION

Short metaphyseal stems provide better functional outcomes with early mobilization, and its long-term follow-up without subsidence, implant loosening, or proximal femoral bone loss simplifies revision surgery in younger patients.

Keywords: Short stem total hip replacement; Short metaphyseal stem; Uncemented hip replacement; Proximal femur osteolysis; Proximal femur bone loss

Core Tip: As the demand for an improved quality of life increases, so does the trend for total hip arthroplasty (THA). This, coupled with longer life expectancy, is expected to lead to more revision surgeries. One of the major issues with traditional femoral stems in THA is stress shielding, which makes revision surgeries particularly difficult in younger patients. Short metaphyseal femoral stems may address this issue, simplifying revision surgeries and improving patient outcomes. This study assessed the long-term results of short-stem THA.