Published online Feb 18, 2022. doi: 10.5312/wjo.v13.i2.139
Peer-review started: April 28, 2021
First decision: June 16, 2021
Revised: July 2, 2021
Accepted: January 7, 2022
Article in press: January 7, 2022
Published online: February 18, 2022
Processing time: 295 Days and 9.3 Hours
The following steps that are necessary to take are the postoperative measurements of the short stem to see if the offset can be restored. Also, a pilot study with gait measurements in a case-matched study of patients with either a short or conventional stem will help to define if there is a difference.
If the native offset was > 80 mm, the short stem was better at restoring FAO than the conventional stem in digital templating. This could indicate that there is a specific patient population that could benefit if a short stem with a curve is chosen as femoral stem instead of the conventional stem.
A FAO more than 80mm showed a large failure rate in restoration in the conventional stems, whereas the short stem could restore the offset in all cases. The reliability of all measurements were good between in both inter- as intra-reliability, with no difference in experience.
Digital templating in a standardized X-ray of the hip were used from two ongoing cohorts, varying in hip anatomy. Orthoview was used as digital templating program. Pre-templating FAO was measured, as well as post-templating FAO measurements in the short and conventional stem. The results were divided into restored (< 5 mm difference in offset) or not-restored (> 5 mm difference in offset).
Primary objective was the femoroacetabular offset restoration in all types of hip anatomy between a short and conventional hip stem, where the acetabular component is used as a fixed parameter. Second objectives were the reliability of the measurements.
As digital templating is a reliable tool for measuring component sizes in total hip arthroplasty, this is used as measurement to see if there is a difference between a short and conventional hip stem in a wide range of hip anatomy.
Short stems are gaining popularity, as one of the possible advantages is the restoration of offset. Offset restoration improves functional outcome. This could benefit the younger patient population, as they have higher expectations of their total hip arthroplasty in their more active lifestyle.