Short-Stem Total Hip Arthroplasty in Patients With Femoral Shaft Deformity: A Propensity Score Matching Study

Background Although corrective osteotomies, hip resurfacing, or custom implants can be used to treat patients with femoral shaft deformity (FSD), these have some limitations. This study aims to assess the clinical and radiological results of a short-stem design in patients with and without FSD. Methods A retrospective analysis of a prospectively collected database of patients with FSD treated with a short femoral stem was conducted over a minimum follow-up period of 1-year. Data were collected for 16 patients with FSD. From a cohort of 451 patients without deformity, propensity score matching was used to form a 32-patient control group. Clinical results were evaluated with the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and the Harris Hip Score preoperatively, and at 1 month, 3 months, 1-year, and every 2 years thereafter. The stability of the fixation was evaluated using Engh's criteria. Results The mean follow-up was 6.87 years. Surgical time was longer in the deformity group (98.7 vs 79.3 minutes; P = .012). There was no intraoperative complication related to the femoral stem, and no aseptic loosening was identified at the time of the latest follow-up. One failure was observed in the deformity group, related to a broken stem at 7 years of follow-up. At 1 year, considerable improvements in Harris Hip Score and WOMAC scores were obtained, but no statistically significant differences were detected between the groups. Conclusions The short-stem design analyzed can be considered a viable option in patients with FSD, with similar results as in patients without deformity. However, longer-term follow-up is required.