Primary outcomes of a femoral neck-preserving stem: a multicentre clinical-radiological analysis at 5-year follow-up

Eur J Orthop Surg Traumatol. 2022 Apr;32(3):533-540. doi: 10.1007/s00590-021-03000-5. Epub 2021 May 26.

Abstract

Purpose: The aim of this prospective study was to evaluate the clinical-radiological outcomes of the Alteon Neck Preserving Stem (ANPS) (Exactech, Gainesville, FL, USA) implanted in four different centres by five senior hip surgeons with a minimum of 5 years of follow-up.

Material and method: We conducted a multicentre prospective study that analysed 155 consecutive total hip replacements during 2014. We performed clinical-radiological analysis measuring Harris Hip Score (HHS), subjective satisfaction evaluation, radiolucencies, position of components, limb length discrepancy, heterotopic ossification, medical and surgical complications and a survival analysis at 5 years follow-up.

Results: Thigh pain was reported in 5 cases (3.2%), 2 of which reported mild pain, 2 moderate, and 1 severe. In 2 cases, subsidences of 3 mm were detected in the first scheduled X-ray, both related to intraoperative fractures with no progression after 3 months. The overall complication rate was 5.8% and 6 of the 9 complications were in the first 30 cases. Mean HHS improved from 42.9 points (range 37.2-55.7 points) preoperatively to 94.9 on average (range 87-98) at the end of the follow-up (p <0.01). Subjective evaluation was excellent in 130 (83.87%) cases and good in 25 patients (16.13%).

Conclusions: The clinical-radiographic results of ANPS THR are satisfactory. The mid-term results are promising. However, long-term follow-up studies are necessary to confirm the validity of the concept.

Keywords: Alteon stem; Femoral neck preservation; Short stem; Total hip replacement; Uncemented stem.

Publication types

  • Multicenter Study

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Hip* / methods
  • Femur Neck / diagnostic imaging
  • Femur Neck / surgery
  • Follow-Up Studies
  • Hip Prosthesis* / adverse effects
  • Humans
  • Prospective Studies
  • Prosthesis Design
  • Treatment Outcome