Skip to main content

Advertisement

SpringerLink
Log in

Ten year results of the collum femoris preserving total hip replacement: a prospective cohort study of seventy five patients

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The collum femoris preserving (CFP) uncemented prosthesis has a bone-preserving, high subcapital neck resection and a short anatomical stem. The ideal arthroplasty option in the younger, active patient is a subject of some debate. We evaluated midterm outcomes of the CFP in this patient population.

Methods

A prospective, consecutive cohort of 75 CFP total hip replacement (THR) patients with a mean age of 52 years was followed for a mean of 9.3 years. Patients were assessed using the Harris Hip Score (HHS). Pain was assessed using a visual analogue scale (VAS) and activity levels using the University of California, Los Angeles (UCLA) score. Radiographs were evaluated for evidence of loosening. Survivorship was calculated with an endpoint of revision for aseptic loosening or radiographic evidence of loosening.

Results

Mean HHS improved from a mean of 50 pre-operatively to 91 (p < 0.001) postoperatively. Mean pain score was 1, mean patient satisfaction was 9 and mean UCLA score was 6. Two acetabular components were revised for aseptic loosening; no stem required revision. Radiographically, no cases had evidence of loosening. Survivorship was 96.8 % for the acetabular component and 100 % for the stem at ten years. Three patients died from unrelated causes, and five were lost to follow-up.

Conclusions

Bone-preserving hip replacement has increased in popularity as hip replacement in younger and more active individuals increases. The CFP prosthesis has excellent midterm clinical function and survival and provides high levels of satisfaction in young patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Medicines and Healthcare products Regulatory Agency (MHRA) www.mhra.gov.u. (2012) Press release: MHRA updates advice for metal-on-metal hip replacements. Available at: http://www.mhra.gov.uk/NewsCentre/Pressreleases/CON143784. Accessed March 12 2013

  2. The National Joint Registry for England and Wales 2011 8th Annual Report. Available at: http://www.njrcentre.org.uk/NjrCentre/Portals/0/Documents/NJR%208th%20Annual%20Report%202011.pdf

  3. Langton DJ, Joyce TJ, Jameson SS et al (2011) Adverse reaction to metal debris following hip resurfacing: The influence of component type, orientation and volumetric wear. J Bone Joint Surg Br 93(2):164–171

    Article  CAS  PubMed  Google Scholar 

  4. Ghera S, Pavan L (2009) The DePuy Proxima hip: A short stem for total hip arthroplasty. Early experience and technical considerations. Hip Int 19(3):215–220

    PubMed  Google Scholar 

  5. Schmidutz F, Grote S, Pietschmann M et al (2012) Sports activity after short-stem hip arthroplasty. Am J Sports Med 40(2):425–432

    Article  PubMed  Google Scholar 

  6. Pipino F, Molfetta L (1993) Femoral neck preservation in total hip replacement. Ital J Orthop Traumatol 19(1):5–12

    CAS  PubMed  Google Scholar 

  7. Biggi F, Franchin F, Lovato R, Pipino F (2004) DEXA evaluation of total hip arthroplasty with neck-preserving technique: 4-year follow-up. J Orthop Traumatol 5(3):156–159

    Article  Google Scholar 

  8. Carlson L, Albrektsson B, Freeman MA (1988) Femoral neck retention in hip arthroplasty. A cadaver study of mechanical effects. Acta Orthop Scand 59(1):6–8

    Article  CAS  PubMed  Google Scholar 

  9. Pipino F, Molfetta L, Grandizio M (2000) Preservation of the femoral neck in hip arthroplasty: Results of a 13-to 17-year follow-up. J Orthop Traumatol 1(1):31–39

    Article  Google Scholar 

  10. Jantsch S, Schwägerl W, Zenz P, Semlitsch M, Fertschak W (1991) Long-term results after implantation of McKee-Farrar total hip prostheses. Arch Orthop Trauma Surg 110(5):230–237

    Article  CAS  PubMed  Google Scholar 

  11. Dobbs HS (1980) Survivorship of total hip replacements. J Bone Joint Surg Br 62-B(2):168–173

    CAS  PubMed  Google Scholar 

  12. Chana R, Esposito C, Campbell PA, Walter WK, Walter WL (2012) Mixing and matching causing taper wear: Corrosion associated with pseudotumour formation. J Bone Joint Surg Br 94(2):281–286

    Article  CAS  PubMed  Google Scholar 

  13. Gill IR, Gill K, Jayasekera N, Miller J (2008) Medium term results of the collum femoris preserving hydroxyapatite coated total hip replacement. Hip Int 18(2):75–80

    CAS  PubMed  Google Scholar 

  14. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755

    CAS  PubMed  Google Scholar 

  15. Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplasty 13(8):890–895

    Article  CAS  PubMed  Google Scholar 

  16. Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: A radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27

    PubMed  Google Scholar 

  17. DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32

    PubMed  Google Scholar 

  18. Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128

    PubMed  Google Scholar 

  19. Rothman KJ (1978) Estimation of confidence limits for the cumulative probability of survival in life table analysis. J Chronic Dis 31(8):557–560

    Article  CAS  PubMed  Google Scholar 

  20. Marchetti P, Binazzi R, Vaccari V et al (2005) Long-term results with cementless Fitek (or Fitmore) cups. J Arthroplasty 20(6):730–737

    Article  PubMed  Google Scholar 

  21. FASTSTATS - Inpatient Surgery. Available at: http://www.cdc.gov/nchs/fastats/insurg.htm. Accessed May 18, 2012

  22. Iorio R, Robb WJ, Healy WL et al (2008) Orthopaedic surgeon workforce and volume assessment for total hip and knee replacement in the United States: Preparing for an epidemic. J Bone Joint Surg 90(7):1598–1605

    Article  PubMed  Google Scholar 

  23. Sadoghi P, Schröder C, Fottner A, Steinbrück A, Betz O, Müller PE, Jansson V, Hölzer A (2012) Application and survival curve of total hip arthroplasties: A systematic comparative analysis using worldwide hip arthroplasty registers. Int Orthop Nov 36(11):2197–203

    Article  Google Scholar 

  24. Briem D, Schneider M, Bogner N et al (2011) Midterm results of 155 patients treated with a collum femoris preserving (CFP) short stem prosthesis. Int Orthop 35(5):655–660

    Article  PubMed Central  PubMed  Google Scholar 

  25. Morrey BF, Adams RA, Kessler M (2000) A conservative femoral replacement for total hip arthroplasty a prospective study. J Bone Joint Surg Br 82-B(7):952–958

    Article  Google Scholar 

  26. Bojescul JA, Xenos JS, Callaghan JJ, Savory CG (2003) Results of porous-coated anatomic total hip arthroplasty without cement at fifteen years: A concise follow-up of a previous report. J Bone Joint Surg Am 85-A(6):1079–1083

    CAS  PubMed  Google Scholar 

  27. Ender SA, Machner A, Pap G, Hubbe J, Grashoff H, Neumann H-W (2007) Cementless CUT femoral neck prosthesis: Increased rate of aseptic loosening after 5 years. Acta Orthop 78(5):616–621

    Article  PubMed  Google Scholar 

  28. Gilbert RE, Salehi-Bird S, Gallacher PD, Shaylor P (2009) The mayo conservative hip: Experience from a district general hospital. Hip Int 19(3):211–214

    PubMed  Google Scholar 

  29. Ling RSM, Charity J, Lee AJC, Whitehouse SL, Timperley AJ, Gie GA (2009) The long-term results of the original Exeter polished cemented femoral component: A follow-up report. J Arthroplasty 24(4):511–517

    Article  PubMed  Google Scholar 

  30. Vidalain J-P (2011) Twenty-year results of the cementless Corail stem. Int Orthop 35(2):189–194

    Article  PubMed Central  PubMed  Google Scholar 

  31. Kress AM, Schmidt R, Nowak TE, Nowak M, Haeberle L, Forst R, Mueller LA (2012) Stress-related femoral cortical and cancellous bone density loss after collum femoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography. Arch Orthop Trauma Surg 132(8):1111–1119

    Article  PubMed  Google Scholar 

  32. Nowak M, Nowak TE, Schmidt R, Forst R, Kress AM, Mueller LA (2011) Prospective study of a cementless total hip arthroplasty with a collum femoris preserving stem and a trabeculae oriented pressfit cup: Minimun 6-year follow-up. Arch Orthop Trauma Surg 131(4):549–555

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK

    Jonathan Hutt, Fadhil Kashif & John Miller

  2. Trauma & Orthopaedics, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK

    Ziad Harb

  3. Trauma & Orthopaedics, Kingston Hospital, London, UK

    Ian Gill

  4. Trauma & Orthopaedics, Morriston Hospital, Swansea, UK

    Matthew Dodd

Authors
  1. Jonathan Hutt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ziad Harb
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ian Gill
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fadhil Kashif
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Matthew Dodd
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ziad Harb.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hutt, J., Harb, Z., Gill, I. et al. Ten year results of the collum femoris preserving total hip replacement: a prospective cohort study of seventy five patients. International Orthopaedics (SICOT) 38, 917–922 (2014). https://doi.org/10.1007/s00264-013-2212-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-013-2212-y

Keywords

Search

Navigation