PMID- 34938623
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240404
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 11
DP  - 2021 Nov
TI  - Different Designs of Proximal Femoral Stems for Total Hip Arthroplasty: Mid-Term 
      Clinical and Patient-Reported Functional Outcomes.
PG  - e19745
LID - 10.7759/cureus.19745 [doi]
LID - e19745
AB  - INTRODUCTION: A comprehensive comparison of the performance of different femoral 
      stem geometries in total hip arthroplasty (THA) is yet to be described. The 
      primary aim of this study was to evaluate objective and subjective outcome 
      measures in primary THA with different femoral implant styles. METHODS: Stems 
      were classified into the following five classes: cemented, conical, fit and fill, 
      modular, and wedge. The objective outcomes of interest were the length of 
      inpatient hospital stay (LOS), 90-day readmission rate, one-year revision rate, 
      and two-year mortality rate. Preoperative and postoperative patient-reported 
      outcome measures (PROMs), including hip disability and osteoarthritis outcome 
      score (HOOS) - physical function shortform (HOOS-PS), patient-reported outcomes 
      measurement information system physical function short form 10a (PROMIS PF-10a), 
      and patient-reported outcomes measurement information system - short form - 
      mental 10a (PROMIS M-10a) were recorded and compared between different classes. 
      RESULTS: Patients with a wedge stem had a significantly lower LOS versus every 
      other stem group, while patients with a cemented stem had the highest LOS, 
      approximately twofold that of the wedge stem group. Accounting for potential 
      confounders, the conical and fit and fill groups had a significantly higher 
      two-year mortality rate than the wedge stem group. Fit and fill stems conferred a 
      slight risk of revision THA at one-year compared to wedge stems. There was no 
      significant difference in the rates of failure to achieve the minimal clinically 
      important difference (MCID) for the PROMs. CONCLUSION: Placement of wedge stems 
      resulted in a significantly lower LOS compared to every other stem class and a 
      lower mortality rate than the conical, fit and fill, and modular stems. As for 
      the 90-day readmission, one-year revision, and the rates of failure to achieve 
      the MCID for general or hip-specific PROMs, stem design had no meaningful effect.
CI  - Copyright (c) 2021, Katakam et al.
FAU - Katakam, Akhil
AU  - Katakam A
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
FAU - Hosseinzadeh, Shayan
AU  - Hosseinzadeh S
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
FAU - Humphrey, Tyler J
AU  - Humphrey TJ
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
FAU - Collins, Austin
AU  - Collins A
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
FAU - Shin, David
AU  - Shin D
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
FAU - Melnic, Christopher M
AU  - Melnic CM
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
FAU - Bragdon, Charles
AU  - Bragdon C
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
FAU - Bedair, Hany S
AU  - Bedair HS
AD  - Orthopaedics, Massachusetts General Hospital, Harvard Medical School, Boston, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20211119
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8684824
OTO - NOTNLM
OT  - femoral stem design
OT  - hoos
OT  - patient reported outcome measures
OT  - promis
OT  - total hip arthroplasty (tha)
COIS- The authors have declared financial relationships, which are detailed in the next 
      section.
EDAT- 2021/12/24 06:00
MHDA- 2021/12/24 06:01
PMCR- 2021/11/19
CRDT- 2021/12/23 05:51
PHST- 2021/11/19 00:00 [accepted]
PHST- 2021/12/23 05:51 [entrez]
PHST- 2021/12/24 06:00 [pubmed]
PHST- 2021/12/24 06:01 [medline]
PHST- 2021/11/19 00:00 [pmc-release]
AID - 10.7759/cureus.19745 [doi]
PST - epublish
SO  - Cureus. 2021 Nov 19;13(11):e19745. doi: 10.7759/cureus.19745. eCollection 2021 
      Nov.