Same same but different: Introduction of a classification system in calcar-guided short-stem total hip arthroplasty.

Background: The concept of calcar-guided short-stem THA (ssTHA) has largely emerged over the last decade, especially in Europe, and today modern calcar-guided short stems are among the most successful primary femoral implants in terms of complications and revision rates as indicated by multiple registry data. The philosophy originally comprised an individualised reconstruction of the hip anatomy by following the calcar of the femoral neck providing bone- and soft-tissue-sparing characteristics. However, as the stem design allows either metaphyseal fixation alone or additional diaphyseal anchoring, depending on the stem alignment and indication, distinct knowledge is required regarding the implantation technique, the broad variation of positioning and fixation and its potential clinical consequences.

Calcar-guided short-stem total hip arthroplasty in fractures of the femoral neck: a prospective observational study of 68 hips.

Introduction: The indications for cementless short-stem total hip arthroplasty (THA) have been expanded due to encouraging results. However, no evidence in cases of femoral neck fractures (FNFs) is available. We aimed to prospectively obtain data on the safety and the clinical outcomes of a cementless calcar-guided short stem in patients with FNFs.

An isoelastic monoblock cup versus a modular metal-back cup: a matched-pair analysis of clinical and radiological results using Einzel-Bild-Röntgen-Analyse software.

Introduction: Bone preservation and long-term survival are the main challenges in cementless total hip arthroplasty (THA). A good bone stock is especially important for adequate anchorage of the cup in revision cases. However, the optimal acetabular cup design for preserving good bone stock is still unclear.

Conversion of failed internal fixation in proximal femur fractures using calcar-guided short-stem total hip arthroplasty.

Purpose: Reoperations for secondary osteoarthritis, osteonecrosis, or hardware failure following failed internal fixation after intertrochanteric fracture (ITF) or femoral neck fracture (FNF) are common. An effective salvage treatment often involves complete removal of the hardware followed by total hip arthroplasty (THA). Almost no data are available regarding conversion to short-stem THA.

[The challenge of revising a well-fixed curved calcar-guided short stem in total hip arthroplasty: Introduction of a new curved extraction chisel system].

Objective: Safe and bone-conserving extraction of a well-fixed curved short stem without the necessity of a transfemoral approach.

Indications: The revision of a well-fixed curved short stem, for example, due to periprosthetic infection or malposition. Meticulous preparation of the cone and the lateral shoulder of the stem.

Cementless Short Stems in Total Hip Arthroplasty: Chances and Limits.

In recent decades, a large number of cementless short stems have been introduced to the market. The concept aims at saving soft tissue using minimally invasive surgery and at the same time preserving as much bone as possible. In particular, the latest generation of short stems, which are implanted using a calcar-guided round-the-corner technique, are attracting increasing attention.

Survivorship, complications and patient-reported outcomes in calcar-guided short-stem THA: prospective mid-term multicenter data of the first 879 hips.

Introduction: Short stems are a bone and soft-tissue preserving alternative to conventional stems. The aim of this multicenter study is to present the mid-term outcomes of a calcar-guided short stem.

Materials And Methods: This is a prospective case series of the first 879 total hip arthroplasties performed on 782 patients across 5 centers using identical calcar-guided short stems.

One-stage bilateral versus unilateral short-stem total hip arthroplasty: A matched-pair analysis of 216 hips.

Background: One-stage, bilateral, short-stem total hip arthroplasty (1B-ssTHA) represents an alternative to staged, unilateral, short-stem total hip arthroplasty (U-ssTHA); however, the safety and reliability of 1B-ssTHA remain unknown. The objective of the present study was to compare the functional outcomes, complications, and mortality rates between 1B-ssTHA and U-ssTHA at mid-term.

Methods: A retrospective, matched-pair study was performed, including 216 short stems implanted in 162 patients.

Downsizing in total hip arthroplasty. A short stem as a revision implant.

Background: Short stems have constantly gained popularity in primary total hip arthroplasty (THA) over the last decade. Although cementless short stems are not primarily designed to be used as revision implants, there may be certain indications for which downsizing the femoral component in failed conventional THA is potentially advantageous.

Methods: In this single center retrospective case series, six patients who underwent revision using a calcar-guided short stem after failed THA are presented.

Calcar-guided short-stem total hip arthroplasty: Will it be the future standard? Review and perspectives.

Short stems in total hip arthroplasty (THA) are becoming increasingly popular. In Germany, already 10.4% of all primary THAs are performed using a cementless short stem.

Can hip resurfacing be safely revised with short-stem total hip arthroplasty? A case series of six patients.

Background: The usage of short stems in primary total hip arthroplasty (THA) has constantly gained popularity over the last decade, however, to date, short stems are not eligible to be used as revision implants. The aim of this study was to retrospectively evaluate the outcome of revision surgery of failed hip resurfacing arthroplasty (HRA) using short-stem THA.

Methods: In a single center, retrospective analysis, 6 consecutive patients who were treated with a calcar-guided short stem after failure of HRA were evaluated.

Future burden of primary and revision hip arthroplasty in Germany: a socio-economic challenge.

Introduction: Total hip arthroplasty (THA) rates have increased dramatically in the recent decades worldwide, with Germany being one of the leading countries in the prevalence of THA. Simultaneously, a rising number of revision procedures is expected, which will put an enormous economic burden on future health care systems.

Methods: Nationwide data provided by the Federal Statistical Office of Germany were used to quantify primary and revision arthroplasty rates as a function of age and gender.

Biomechanics of a cemented short stem: a comparative in vitro study regarding primary stability and maximum fracture load.

Purpose: In total hip arthroplasty, uncemented short stems have been used more and more frequently in recent years. Especially for short and curved femoral implants, bone-preserving and soft tissue-sparing properties are postulated. However, indication is limited to sufficient bone quality.

Secondary Osseous Integration of Cementless Unicompartmental Knee Arthroplasty After Internal Fixation of a Felix Type IIIB Fracture: A Case Report.

Case: A 76-year-old man presented with periprosthetic tibial plateau fracture (TPF), with a completely loosened tibial component 3 weeks after cementless unicompartmental knee arthroplasty (UKA). Internal fixation by buttress plating was performed, and the tibial component was retained and left in situ primarily as a spacer. Revision was planned after fracture consolidation, but at 3 months, the patient was able to walk without support, without pain, and with full range of motion.

The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: radiological analyses of migration and wear using EBRA and clinical outcomes at mid-term follow-up.

Background: The newest generation of cementless titanium-coated, isoelastic monoblock cup with vitamin E-blended highly cross-linked polyethylene (HXLPE) was introduced to the market in 2009. The aim of the present study was to obtain mid-term follow-up data including migration and wear analyses.

Methods: This prospective study investigated 101 primary total hip arthroplasty (THA) cases in 96 patients treated at a single institution.

Cemented short-stem total hip arthroplasty: Characteristics of line-to-line versus undersized cementing techniques using a validated CT-based finite element analysis.

Short stems are becoming increasingly popular in total hip arthroplasty as they preserve the bone stock and simplify the implantation process. Short stems are advised mainly for patients with good bone stock. The clinical use of short stems could be enlarged to patients with poor bone stock if a cemented alternative would be available.

Primary stability of calcar-guided short-stem total hip arthroplasty in the treatment of osteonecrosis of the femoral head: migration analysis using EBRA-FCA.

Introduction: Osteonecrosis of the femoral head (ONFH) is a disabling condition that often results in secondary arthritis necessitating total hip arthroplasty (THA). Short-stem THA has constantly gained popularity. It remains controversial, whether ONFH represents a risk factor for failure after the implantation of short stems with pronounced metaphyseal anchorage.

The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years.

Purpose: Total knee arthroplasty (TKA) rates have increased substantially in the recent decades worldwide, with Germany being one of the leading countries in the prevalence of TKA. The aim of this study was to provide an overview of treatment changes during the last decade and to project the expected burden of primary and revision TKA (rTKA) for the next 30 years.

Methods: Comprehensive nationwide data from Germany was used to quantify primary and revision TKA rates as a function of age and gender.

Defining 'undersizing' in short-stem total hip arthroplasty: the importance of sufficient contact with the lateral femoral cortex.

Introduction: Undersizing is 1 of the main reasons for early implant failure. Adequate sizing in short-stem total hip arthroplasty can be challenging and, so far, lacks key decision criteria.

Methods: We included 191 calcar-guided short stems.

A novel calibration method for digital templating of total hip arthroplasty: a prospective clinical study of dual scale type single marker calibration in supine radiographs.

Background: External calibration markers (ECM) are the standard of care for digital templating in joint replacements. Spherical mono markers are known to be unreliable. Fixed calibration factors (FCF) can reduce the overall error by placement of markers, but do not address individual patient anatomy.

Mid-term migration pattern of a calcar-guided short stem: A five-year EBRA-FCA-study.

Background: Short-term results of several short-stem designs have indicated early axial migration. Mid- and long-term results for most designs are lacking. The objective of this study was to evaluate the mid-term migration pattern of a calcar-guided short stem five years postoperative.

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

Background: The number of total hip arthroplasties (THA) is rising in many industrialized nations. At the same time, the evidence regarding different types of prostheses and fixation techniques is constantly evolving. Therefore, this study aimed to analyze changes in THA by these advancements during the last decade.

Mid-term results of a new-generation calcar-guided short stem in THA: clinical and radiological 5-year follow-up of 216 cases.

Background: In recent years, a variety of short stems have been introduced. To date, mid- and long-term results of calcar-guided short-stem designs have been rarely available.

Materials And Methods: Two hundred and sixteen calcar-guided short stems were included in combination with a cementless cup in a prospective study.