Skip to main content
SpringerLink
Log in

Migration pattern of a femoral short-stem prosthesis: a 2-year EBRA-FCA-study

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Short-stem prostheses enable bone stock preserving total hip arthroplasty. However, little is known about the durability of this group of implants. The most common cause for implant failure is aseptic loosening. Early implant migration is supposed to be the best indicator for mechanical failure of femoral stems. The purpose of this study was to evaluate the migration pattern of a short stem implant and the influence of BMI, gender and femoral offset on implant migration.

Materials and methods

After a minimum follow-up of 2 years, 72 hips were included in this EBRA-FCA-study. The mean age at surgery of the 34 female and 32 male patients was 54 years (range 22–75 years). The mean BMI was 29 kg/m2 (range 21–51 kg/m2).

Results

Mean axial subsidence was 1 mm (±1.4 mm) after 24 months. BMI, gender and implant offset did not influence implant migration on a statistical significant level. Nevertheless, a tendency towards more migration in obese and female patients was observed.

Conclusion

The evaluated short stem prosthesis showed a migration pattern similar to clinical proven standard straight stem implants. The indication of short-stem prostheses should be critically evaluated in obese and female patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet 370(9597):1508–1519

    Article  PubMed  Google Scholar 

  2. Kärrholm J, Garellick G, Rogmark C, Rolfson O, Herberts P (2012) Swedish HIP Arthroplasty Register: annual report 2011. Sahlgrenska University Hospital, Sahlgrenska

    Google Scholar 

  3. Coulter G, Young DA, Dalziel RE, Shimmin AJ (2012) Birmingham hip resurfacing at a mean of ten years: results from an independent centre. J Bone Jt Surg Br 94(3):315–321

    Article  CAS  Google Scholar 

  4. Powers-Freeling L (2012) National Joint Registry for England and Wales. 9th annual report 2012. Available from: http://www.njrcentre.org.uk/NjrCentre/Portals/0/Documents/England/Reports/9th_annual_report/NJR. 9th Annual Report 2012.pdf

  5. Johanson PE, Fenstad AM, Furnes O, Garellick G, Havelin LI, Overgaard S et al ((2010)) Inferior outcome after hip resurfacing arthroplasty than after conventional arthroplasty. Evidence from the Nordic Arthroplasty Register Association (NARA) database, 1995 to 2007. Acta Orthop 81(5):535–541

    Article  Google Scholar 

  6. AQUA (2012) Hüftendoprothesenversorgung. Göttingen: AQUA—Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH

  7. Khanuja HS, Vakil JJ, Goddard MS, Mont MA (2011) Cementless femoral fixation in total hip arthroplasty. J Bone Jt Surg Am 93(5):500–509

    Article  Google Scholar 

  8. Bieger R, Ignatius A, Decking R, Claes L, Reichel H, Durselen L ((2012)) Primary stability and strain distribution of cementless hip stems as a function of implant design. Clin Biomech (Bristol, Avon) 27(2):158–164

    Article  Google Scholar 

  9. Krismer M, Biedermann R, Stockl B, Fischer M, Bauer R, Haid C (1999) The prediction of failure of the stem in THR by measurement of early migration using EBRA-FCA. Einzel-Bild-Roentgen-analyse-femoral component analysis. J Bone Jt Surg Br 81(2):273–280

    Article  CAS  Google Scholar 

  10. Bieger R, Ignatius A, Reichel H, Durselen L (2013) Biomechanics of a short stem: in vitro primary stability and stress shielding of a conservative cementless hip stem. J Orthop Res 31(8):1180–1186

    Article  PubMed  Google Scholar 

  11. Karrholm J (2012) Radiostereometric analysis of early implant migration—a valuable tool to ensure proper introduction of new implants. Acta Orthop 83(6):551–552

    Article  PubMed Central  PubMed  Google Scholar 

  12. Karrholm J, Herberts P, Hultmark P, Malchau H, Nivbrant B, Thanner J (1997) Radiostereometry of hip prostheses. Review of methodology and clinical results. Clin Orthop Relat Res 344:94–110

    PubMed  Google Scholar 

  13. Biedermann R, Krismer M, Stockl B, Mayrhofer P, Ornstein E, Franzen H (1999) Accuracy of EBRA-FCA in the measurement of migration of femoral components of total hip replacement. Einzel-Bild-Rontgen-analyse-femoral component analysis. J Bone Jt Surg Br 81(2):266–272

    Article  CAS  Google Scholar 

  14. Wilkinson JM, Hamer AJ, Elson RA, Stockley I, Eastell R (2002) Precision of EBRA-digital software for monitoring implant migration after total hip arthroplasty. J Arthroplast 17(7):910–916

    Article  CAS  Google Scholar 

  15. Lazarinis S, Mattsson P, Milbrink J, Mallmin H, Hailer NP (2013) A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA: primary stability but no prevention of proximal bone loss in 27 patients followed for 2 years. Acta Orthop 84(1):32–39

    Article  PubMed Central  PubMed  Google Scholar 

  16. Schmidutz F, Graf T, Mazoochian F, Fottner A, Bauer-Melnyk A, Jansson V (2012) Migration analysis of a metaphyseal anchored short-stem hip prosthesis. Acta Orthop 83(4):360–365

    Article  PubMed Central  PubMed  Google Scholar 

  17. Floerkemeier T, Tscheuschner N, Calliess T, Ezechieli M, Floerkemeier S, Budde S et al (2012) Cementless short stem hip arthroplasty METHA(R) as an encouraging option in adults with osteonecrosis of the femoral head. Arch Orthop Trauma Surg 132(8):1125–1131

    Article  PubMed  Google Scholar 

  18. Ruben RB, Fernandes PR, Folgado J (2012) On the optimal shape of hip implants. J Biomech 45(2):239–246

    Article  PubMed  Google Scholar 

  19. Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95(1–2):47–49

    Article  CAS  PubMed  Google Scholar 

  20. Morrey BF, Adams RA, Kessler M (2000) A conservative femoral replacement for total hip arthroplasty. A prospective study. J Bone Jt Surg Br 82(7):952–958

    Article  CAS  Google Scholar 

  21. Gustke K ((2012)) Short stems for total hip arthroplasty: Initial experience with the Fitmore stem. J Bone Jt Surg Br 94-B(11 Suppl):47–51

    Article  Google Scholar 

  22. Wolf O, Mattsson P, Milbrink J, Larsson S, Mallmin H (2010) Periprosthetic bone mineral density and fixation of the uncemented CLS stem related to different weight bearing regimes: a randomized study using DXA and RSA in 38 patients followed for 5 years. Acta Orthop 81(3):286–291

    Article  PubMed Central  PubMed  Google Scholar 

  23. Jacobs CA, Christensen CP (2009) Progressive subsidence of a tapered, proximally coated femoral stem in total hip arthroplasty. Int Orthop 33(4):917–922

    Article  PubMed Central  PubMed  Google Scholar 

  24. Patel RM, Smith MC, Woodward CC, Stulberg SD (2012) Stable fixation of short-stem femoral implants in patients 70 years and older. Clin Orthop Relat Res 470(2):442–449

    Article  PubMed Central  PubMed  Google Scholar 

  25. Rohrl SM, Li MG, Pedersen E, Ullmark G, Nivbrant B (2006) Migration pattern of a short femoral neck preserving stem. Clin Orthop Relat Res 448:73–78

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Semra Kocak for the statistical analysis.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Centre of Musculoskeletal Research, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany

    Tobias Freitag, Thomas Kappe, Michael Fuchs, Sebastian Jung, Heiko Reichel & Ralf Bieger

Authors
  1. Tobias Freitag
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Kappe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Fuchs
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sebastian Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Heiko Reichel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ralf Bieger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ralf Bieger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Freitag, T., Kappe, T., Fuchs, M. et al. Migration pattern of a femoral short-stem prosthesis: a 2-year EBRA-FCA-study. Arch Orthop Trauma Surg 134, 1003–1008 (2014). https://doi.org/10.1007/s00402-014-1984-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-014-1984-x

Keywords

Search

Navigation