No effect of conventional vs. minimally invasive surgical approach on clinical outcome and migration of a short stem total hip prosthesis at 2-year follow-up: A randomized controlled study. (January 2018)

• Record Type: Journal Article
• Authors: Schwarze, Michael; Budde, Stefan; von Lewinski, Gabriela; Windhagen, Henning; Keller, Marie Christina; Seehaus, Frank; Hurschler, Christof; Floerkemeier, Thilo
• Is Part Of: Clinical biomechanics. Volume 51(2018)
• Page Start: 105
• Page End: 112
• Publication Date: 2018-01
• Subjects: RSA -- Primary THA -- Short stem implant -- Migration -- Clinical scores; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2017.12.004
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: Short stem hip prostheses have become a viable alternative for the treatment of hip osteoarthritis. In combination with minimally invasive surgery, short stem hip prostheses offer potential advantages of reduced surrounding tissue damage and faster rehabilitation. However, the limited perioperative visibility of these minimally invasive techniques may lead to reduced primary stability compared to conventional techniques. We hypothesized: a) increased migration of the minimally invasive group due to reduced primary stability and b) increased clinical scores of the minimally invasive group. Methods: Sixty total hip arthroplasty patients were randomly assigned to undergo minimally invasive anterolateral modified Watson-Jones or conventional Hardinge surgery. All patients were treated with a Metha short stem prosthesis. Roentgen stereophotogrammetry and clinical scores were calculated after surgery and at 3, 6, 12, and 24 months postoperatively. Findings: No statistically significant differences in implant migration and clinical scores were observed between the minimally invasive and conventional groups at any follow-up point. The largest average resultant migrations were 1.22 (SD 1.31) mm (conventional) and 1.18 (SD 1.18) mm (minimally invasive) after 24 months. The mean Harris Hip Score score improved from 54 (SD 10, conventional) and 52 (SD 13, minimally invasive) preoperatively to 97 (SD 5, both groups) after 24 months. Interpretation: Overall, the differences in implant migration and clinical scores between the minimally invasive and conventional surgery groups were marginal and not clinically relevant. The data from this study suggest that good results can be expected from both the investigated approaches. Highlights: Implant migration of the Metha short stem was not influenced by the choice of conventional or minimally invasive surgery. High accuracy migration data of the Metha short hip stem is reported for the first time. Despite higher migration compared to other short stems, the revision rates of the Metha are average for a short stem.