title: Cementless short stem hip arthroplasty METHA® as an encouraging option in adults with osteonecrosis of the femoral head.
abstract: BACKGROUND
  The implantation of a total hip arthroplasty is the standard treatment for patients with progressive osteonecrosis. However, there is uncertainty about the type of arthroplasty that provides the best outcome and whether short stem arthroplasty represents a reasonable alternative for young patients in order to have more options in case of revision. This uncertainty exists due to the lack of studies analysing contemporary short stem arthroplasty in osteonecrosis.
  
  
  OBJECTIVE
  The aim of this study was to determine the outcome of the METHA(®) short stem arthroplasty in patients with progressive osteonecrosis.
  
  
  METHODS
  This study evaluated the clinical and radiological short- to midterm results after implantation of the cementless short stem arthroplasty METHA(®). 73 hips in 64 patients with progessive osteonecrosis after implantation of the METHA(®) arthroplasty were investigated by measuring the clinical outcome, the Harris Hip Score (HHS) and visual analogue pain scale for the preoperative stage and follow-up. Radiological analyses of X-rays were conducted to assess the bone ingrowth as well as subsidence, osteolysis or fracture.
  
  
  RESULTS
  The pain scale improved from preoperatively 7.8 to postoperatively 1.7, while the HHS increased from 41.4 to 90.6 points 34 months post-surgery. Complications associated with revision of the METHA(®) short stem included two traumatic femoral shaft fracture and one deep infection. The radiological assessment showed good bone ingrowth in all patients despite osteonecrosis.
  
  
  CONCLUSIONS
  The study confirms encouraging results as well as good bone ingrowth of the cementless short stem arthroplasty METHA(®) even in patients with osteonecrosis.
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany. Thilo.Floerkemeier@ddh-gruppe.de
authors.forename: Thilo
authors.initials: T
authors.lastname: Floerkemeier
authors.forename: Nora
authors.initials: N
authors.lastname: Tscheuschner
authors.forename: Tilman
authors.initials: T
authors.lastname: Calliess
authors.forename: Marco
authors.initials: M
authors.lastname: Ezechieli
authors.forename: Stephanie
authors.initials: S
authors.lastname: Floerkemeier
authors.forename: Stefan
authors.initials: S
authors.lastname: Budde
authors.forename: Henning
authors.initials: H
authors.lastname: Windhagen
authors.forename: Gabriela
authors.initials: G
authors.lastname: von Lewinski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult