Clinical and radiographic outcomes after total hip arthroplasty with the NANOS neck preserving hip stem: a 10 to 16-year follow-up study

A Comprehensive Review of Total Hip Arthroplasty Outcomes in Post-traumatic Hip Arthritis: Insights and Perspectives

Post-traumatic hip arthritis presents a challenging condition characterized by degenerative changes in the hip joint following traumatic injury. Total hip arthroplasty (THA) is a cornerstone in managing this condition, offering significant pain relief, functional improvement, and enhanced quality of life. This comprehensive review aims to synthesize existing literature to elucidate the outcomes of THA in post-traumatic hip arthritis, exploring factors influencing surgical success and identifying areas for further research. Key findings reveal favourable clinical outcomes associated with THA, though considerations such as patient characteristics, surgical techniques, and implant selection impact outcomes. Implications for clinical practice underscore the importance of tailored preoperative assessment and ongoing advancements in surgical approaches and implant technology. Furthermore, opportunities for future research lie in long-term durability studies, patient-reported outcomes assessment, and exploration of innovative surgical techniques. Overall, THA emerges as a promising intervention for post-traumatic hip arthritis, yet continual refinement through research and innovation remains imperative to optimize patient care in this population.

What role for short stems in 2023?

Current trends in total hip replacement aim at soft tissue and bone stock conservation. At the same time, mean patient age has been decreasing from decade to decade, raising the issue of iterative revision. Short stems seek to resolve the problem on the femoral side. Hopefully, revision of a short stem will be easier and bone stock depletion will be less than with a standard stem. Short stems also seem to have other advantages: automatically personalized biomechanical reconstruction, easier minimally invasive strategies, very low rate of hip pain, more harmonious distribution of bone stress, etc. Despite these advantages, however, use of short stems since their introduction in the late 1980s has varied from country to country, and is not widespread in France. The present study addressed several questions concerning these implants. Firstly, what is a "short" stem? Then, what are the indications and contraindications? Shortened standard stems do not come under the concept of short stem and will not be dealt with here. Furthermore, the learning curve and specificities of short stems need to be acquired. Implantation technique differs greatly from standard stems, and short stem implantation requires particular rigor. Results also need to be assessed, and especially the rate of complications as compared to standard stems. And lastly, it needs to be determined whether the advantages are real or only theoretical: this will determine their usefulness and role in the armamentarium, in which short stems are a new paradigm. LEVEL OF EVIDENCE: Expert opinion.