Artikel
SMF stem in total hip arthroplasty – three-year follow-up
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Autoren
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Wieslaw Lachowicz
- Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain
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Kay Berg
- Hospital Universitario del Vinalopó (ELCHE), Elche, Spain
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Clara Cobo
- Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain
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Maritere Vargas
- Hospital Universitario de Torrevieja, Torrevieja, Alicante, Spain
| Veröffentlicht: | 23. Oktober 2017 |
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Gliederung
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Objectives: Short-stem total hip arthroplasty can be a bone-conserving procedure and alternative for the younger and active population.
SMF uncemented titanium stem is shorter than conventional stems and intended to allow implantation through minimally invasive approach.
In this study will be presented clinical and radiological outcomes of three-year follow-up.
Methods: In a series of 76 patients (36 females, 40 males), the mean age was 64 years (range 35 - 84 years).
Using Monobloc SMF femoral stem 38 left and 38 right hips was operated.
Indications to operative treatment were 48 patients with primary coxarthrosis (63,2%), 18 with avascular necrosis of the femoral haed (23,7%) and 10 with secandary coxarthrosis (13,1%).
Most of the patients 74(97,4%) was operated with minimally invasive anterior approache (DAA) , 2 with postero-lateral approach (2,6%).
Mean follow-up time was 3 years.
Functional outcomes were analyzed on the basis of Harris Hip and WOMAC scores.
Results and Conclusion: Evaluation of the radiographic outcomes was assessed for:
- malalignment: 5 cases /6,6%/ (IMAGE01, Case 2),
- inappropriate implant sizing: 1 case /1,3%/,
- vertical stem migration subsidence up to 5 mm: 18 cases /23,6%/
- rotational angular stem migration up to 5 degrees : 45 cases /59%/ in the first 3 months after the operation.
- proximal femur neck osteolysis: 16 cases /21%/
- distal femur cortical hypertrophy: 8 cases /10,5%/
Complications included:
- periprosthetic fractures 2 cases /2,6%/ (IMAGE01, Case 1)
- infection : superficial 1 case /1,3%/
- incidence of thigh pain 5 cases /6,6%/
- lateral femoral cutaneous nerve injury (neuropraxia, axonotmesis, neurotmesis): 10 cases /13%/.
- femoral nerve injury (neuropraxia) 2 cases /2,6%/
Average Harris hip score at last follow-up was 91,8 (range 73 - 100), WOMAC score average 88,9 (range 64,1 - 98,4).
The SMF stem can be implanted using minimally invasive direct anterior approach /DAA/, but surgical technique may be technically demanding.
SMF femoral short stem maintains the possibility of using a conventional hip implant if revision is necessary.
At 3-years follow-up survivorship was 98%.
The SMF (Short Modular Femoral Hip System) stem needs long-term follow-up.
