Revision rate after short-stem total hip arthroplasty: a systematic review of 49 studies.
OBJECTIVE
The aim of short-stem total hip arthroplasty is to preserve proximal bone stock for future revisions, to improve biomechanical reconstruction, and to make minimally invasive approaches easier. It is therefore being increasingly considered to be a sound alternative to conventional total hip arthroplasty, especially for young and active patients. However, it is still unknown whether survival rates of short-stem hips match current standards. We made a systematic summary of reported overall survival after short-stem total hip arthroplasty.


METHODS
We conducted a systematic review of English, French, German, and Dutch literature. 2 assessors independently identified clinical studies on short-stem hip arthroplasty. After recalculating reported revision rates, we determined whether each implant had a projected revision rate of 10% or less at 10 years of follow-up or a revision rate per 100 observed component years of 1 or less. Stems were classified as "collum", "partial collum", or "trochanter-sparing".


CONCLUSIONS
We found 49 studies, or 51 cohorts, involving 19 different stems. There was a large increase in recent publications. The majority of studies included had a follow-up of less than 5 years. We found a large number of observational studies on "partial collum" and "trochanter-sparing" stems, demonstrating adequate survival rates at medium-term follow-up. Clinical evidence from "collum stem" studies was limited to a small number of studies with a medium-term follow-up period. These studies did not show a satisfactory overall survival rate.
Department of Orthopedic Surgery , Orthopedic Research Center Amsterdam , Academic Medical Center.
Jakob
J
van Oldenrijk
Jeroen
J
Molleman
Michel
M
Klaver
Rudolf W
RW
Poolman
Daniel
D
Haverkamp
D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D005269:Femur; D006622:Hip Prosthesis; D006801:Humans; D017063:Outcome Assessment, Health Care; D011474:Prosthesis Design; D012086:Reoperation / Q000706:statistics & numerical data; D015996:Survival Rate; D013997:Time Factors