Long-Term Clinical and Radiographic Results of an Ultra-Short Metaphyseal-Fitting Non-Anatomic Cementless Stem in Patients with Femoral Neck Fracture

J Arthroplasty. 2021 Jun;36(6):2105-2109. doi: 10.1016/j.arth.2021.01.029. Epub 2021 Jan 21.

Abstract

Background: The purpose of this study is to determine the clinical and radiographic outcomes, mortality rate, complication rate, and revision rate of this ultra-short non-anatomic cementless femoral stem in elderly patients with a femoral neck fracture.

Methods: We reviewed the results of 284 total hip arthroplasties performed with an ultra-short non-anatomic cementless stem in 280 previously active patients with a mean age of 72.8 ± 13 years (range 49-83). The mean follow-up was 9.3 years (range 7-13).

Results: The mean Harris Hip Score was 86 ± 14 points at final follow-up. The mean Western Ontario and McMaster Universities Osteoarthritis Index score was 24 ± 6 points at the final follow-up. The mean University of California, Los Angeles activity score was 6 points at final follow-up. Osseointegration was seen in all acetabular (100%) and in 276 femoral components (97%). Kaplan-Meier survivorship analysis revealed that the survival rate of the femoral component at 8.3 years was 97% (95% confidence interval 91-100) and that of the acetabular component was 100% (95% confidence interval 94-100) with aseptic loosening or revision as the end point.

Conclusion: An ultra-short non-anatomic cementless femoral stem in patients with good bone quality (Dorr A and some Dorr type B bone) is a safe treatment for femoral neck fracture. In patients with poor bone quality (Dorr C type), the results were very poor, and use of this stem should be avoided.

Keywords: complication; femoral neck fracture; non-anatomic cementless stem; revision; ultra-short.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip*
  • Femoral Neck Fractures*
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Los Angeles
  • Middle Aged
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Treatment Outcome