title: Low Short-Stem Revision Rates: 1-11 Year Results From 1888 Total Hip Arthroplasties.
abstract: In total hip arthroplasty, short stems were developed as a bone-conserving alternative to traditional cementless stems. So far, there have been very few recorded medium to long-term results of these comparatively new implants. The aim of our retrospective study was to report on the survival of calcar-loading short stems.
  
  
  
  All Metha stem implantations from 2004 to 2014 were recorded from the operation protocols (n = 1888). Due to the chronological development of the stem, 3 different versions were implanted: modular titanium stems with neck adapters from titanium or cobalt-chrome and monoblock stems. Patients were questioned by post about revision, dislocation, and satisfaction.
  
  
  
  Data were complete for 93% of the procedures (1090 monoblock stems, 314 modular stems with titanium neck, and 230 modular stems with cobalt chrome neck). Mean follow-up was 6 years (1-11 years). Fifteen modular titanium implants were affected by cone fractures (4%). Therefore, monoblock, modular cobalt chrome, and modular titanium implants were analyzed separately. The 7-year revision rate for monoblock stems was 1.5%; for modular cobalt-chrome stems it was 1.8%, and for modular titanium stems it was 5.3%.
  
  
  
  Our data show the midterm survival of the monoblock and modular cobalt-chrome implants equivalent to the traditional cementless stems. These might, therefore, be considered as a bone-conserving alternative for young and active patients.
authors.affiliation: Clinic of Orthopedic Surgery, St. Vinzenz Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schnurr
authors.affiliation: Clinic of Orthopedic Surgery, St. Vinzenz Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Schellen
authors.affiliation: Clinic for Orthopedic Surgery and Traumatology, University of Cologne, Cologne, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Dargel
authors.affiliation: Department for Endoprosthetics Lower extremity, Sportklinik Stuttgart, Stuttgart, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Beckmann
authors.affiliation: Clinic for Orthopedic Surgery and Traumatology, University of Cologne, Cologne, Germany.
authors.forename: Peer
authors.initials: P
authors.lastname: Eysel
authors.affiliation: Clinic of Orthopedic Surgery, Marienkrankenhaus Kaiserswerth, Düsseldorf, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Steffen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000706:statistics & numerical data; D002858:Chromium Alloys; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design / Q000706:statistics & numerical data*; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014025:Titanium; D055815:Young Adult
chemical_list: D002858:Chromium Alloys; D014025:Titanium
keywords: aseptic loosening; fracture; short stem; survival; total hip arthroplasty