A comparison of uncemented short versus standard stem length in total hip arthroplasty: results from the Dutch Arthroplasty Register

Mirthe H.W. VAN VEGHEL*, Gerjon Hannink, Jakob VAN OLDENRIJK, Liza N. VAN STEENBERGEN, B. Willem Schreurs

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
18 Downloads (Pure)

Abstract

Background and purpose — We aimed to compare revision rates between uncemented short and standard stems in total hip arthroplasties (THAs) and the corresponding patient-reported outcome measures (PROMs). Patients and methods — We included all short (C.F.P., Fitmore, GTS, Metha, Nanos, Optimys, Pulchra, and Taperloc Microplasty) and standard stems in uncemented THAs registered between 2009 and 2021 in the Dutch Arthroplasty Register. Kaplan–Meier survival and multivariable Cox regression analyses were performed with overall and femoral stem revision as endpoints. Results — Short stems were used in 3,352 and standard stems in 228,917 hips. 10-year overall revision rates (4.8%, 95% confidence interval [CI] 3.7–6.3 vs. 4.5%, CI 4.4–4.6) and femoral stem revision rates (3.0%, CI 2.2–4.2 vs. 2.3%, CI 2.2–2.4) were comparable for short- and standard-stem THAs. Today’s predominant short stems (Fitmore and Optimys) showed short-term revision rates similar to that of standard-stem THAs. Other, less frequently used short stems had higher 10-year overall (6.3%, CI 4.7–8.5) and femoral stem (4.5%, CI 3.1–6.3) revision rates. Multivariable Cox regression also showed a higher risk for overall (HR 1.7, CI 1.0–2.9) and femoral stem revision (HR 2.0, CI 1.1–3.5) using the latter short stems compared with standard stems. An exploratory analysis of PROMs showed no difference. Conclusion — There was no overall difference in revision rates but a tendency toward increased revision of short stems both for the whole THA and for the stem itself. The less frequently used short stems had increased revision risk. No difference in PROMs was shown.

Original languageEnglish
Pages (from-to)330-335
Number of pages6
JournalActa Orthopaedica
Volume94
DOIs
Publication statusPublished - 7 Jul 2023

Bibliographical note

Funding Information:
Data was received completely anonymously. Data was available from the LROI, but restrictions apply to the availability of this data, which was used under license for the current study. This study is funded by the Dutch Arthroplasty Register. No conflicts of interest were declared. Completed disclosure forms for this article following the ICMJE template are available on the article page, doi: 10.2340/17453674.2023.13652

Publisher Copyright:
© 2023 The Author(s).

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