Comparison of two different stems for total hip arthroplasty

Abstract

Background: Total hip arthroplasty (THA) is the golden standard in treating severe osteoarthritis, which has not responded to conservative treatment. This study aimed to evaluate and compare the therapeutic results of THA using Short-stem and Standard-stem prostheses. Methods: The study was a randomized clinical trial without a control group that was performed in 2020. A total number of 156 patients were recruited over three years. Patients were divided into two groups. The first group was treated with a Short-stem prosthesis and the second group was treated with a Standard-stem prosthesis. Patients were visited according to a schedule. At each visit, a control graph was prepared and the condition of the bone prosthesis and its position were examined. Also, the status of cane use and weightlifting were evaluated. Clinical signs such as pain, lameness, and the ability to climb stairs were assessed and recorded based on the Harris scale. Patients were also evaluated for surgical complications such as infection or limb length discrepancy. Results: Data of 140 patients were analyzed. The mean age of patients was 60.2 +/- 6.38 years. The amount of bleeding in the short-stem group was significantly lower than the standard-stem group (380.17 ml versus 430.13 ml, P = 0.001). In both groups, there was a significant increase in Harris score after the end of the study compared to before the operations. Furthermore, Harris's mean score was higher in the short-stem group compared to standard-stem group. However, these significant differences were observed only in the sixth week (P < 0.0001) and the third month (P < 0.0001). Conclusion: The use of Short-stem prosthesis in the short term can play a role in improving patient performance but in the long term evaluations, there is no apparent difference with the use of Standard-stem prostheses.