Comparison of collum femoris-preserving stems and ribbed stems in primary total hip arthroplasty

BACKGROUND: This retrospective study investigated the relative benefits of using a collum femoris-preserving prosthesis or ribbed stem during total hip arthroplasty (THA). METHODS: The clinical results were compared of patients who underwent THA, between January 2010 and December 2012, with either a CFP prosthesis or a ribbed stem (66 and 75 patients, respectively, aged 43.4 ± 10.8 and 42.3 ± 9.8 years). Patients were assessed using the Harris Hip Score (HHS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), 12-Item Short Form Health Survey (SF-12), and physical component summary (PCS) score. Intraoperative and postoperative complications and leg-length differences were noted. RESULTS: The mean follow-up times of the CFP and ribbed groups were 67.2 ± 7.5 and 68.3 ± 7.2 months, respectively. The HHS, SF-12 MCS, SF-12 PCS, and WOMAC scores of the two groups were similar. The rates of periprosthetic femoral fractures and leg-length differences > 10 mm in the CFP group (10.6% and 13.6%, respectively) were significantly higher than those in the ribbed group (1.3% and 2.7%). The groups were similar regarding complications of osteolysis, ectopic ossification, dislocation, deep infection, deep venous thrombosis, thigh pain, and aseptic loosening. The survival rates of the CFP and ribbed groups were comparable (98.5% and 97.8%). CONCLUSION: The clinical results of the CFP and ribbed prostheses in young patients given THA were similar for Chinese patients. However, the CFP stem should be used with caution, given the high incidence of technical problems associated with implantation especially for Chinese patients.