Cadera/Hip/Hüfte/Hanche: Vástagos cortos con mucho cuidado

Short Bone-Conserving Stems in Cementless Hip Arthroplasty
Harpal S. Khanuja, Samik Banerjee, Deepak Jain,  Robert Pivec,  Michael A. Mont
J Bone Joint Surg Am, 2014 Oct 15; 96(20):1742-1752

Abstract

➤ Short bone-conserving femoral stems in total hip arthroplasty were designed to preserve proximal bone stock.
➤ Given the distinct fixation principles and location of loading among these bone-conserving stems, a classification system is essential to compare clinical outcomes.
➤ Due to the low quality of currently available evidence, only a weak recommendation can be provided for clinical usage of certain stem designs, while some other designs cannot be recommended at this time.
➤ A high prevalence of stem malalignment, incorrect sizing, subsidence, and intraoperative fractures has been reported in a subset of these short stem designs.
➤ Stronger evidence, including prospective multicenter randomized trials comparing standard stems with these newer designs, is necessary before widespread use can be recommended.