TY - JOUR
T1 - Subsidence and Clinical Impact of Obesity in Short-Stem Total Hip Arthroplasty Using a Collarless, Triple-Tapered, Cementless Stem
AU - Gruber, Michael Stephan
AU - Schöning, Johannes
AU - Bischofreiter, Martin
AU - Kindermann, Harald
AU - Schulz, Arndt Peter
AU - Hinz, Nico
AU - Mayböck, Emanuel
AU - Ortmaier, Reinhold
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/12
Y1 - 2024/12
N2 - Background: Short-stem total hip arthroplasty (THA) has gained popularity due to its bone-sparing technique, but its outcomes in patients with obesity remain uncertain. The aim of this study was to investigate the impact of obesity on postoperative subsidence and clinical outcomes after short-stem THA. Methods: A retrospective cohort study with a minimum follow-up of 24 months was conducted on 163 patients who underwent short-stem THA with a collarless, triple-tapered, cementless stem achieving fixation in the metaphyseal region. Patients were categorized into obesity (Body Mass Index, BMI ≥ 30 kg/m2) and nonobesity (BMI < 30 kg/m2) groups. Subsidence rates, clinical outcomes, and complications were analyzed to assess the influence of BMI on the outcome of short stem THA. Regression analysis was performed to assess the influence of the independent variables (BMI, stem size, deviation from planning) on subsidence. Results: The obesity group (mean follow-up 58.6 months) exhibited significantly greater subsidence rates than did the nonobesity group (mean follow-up 38.9 months; 2.6 mm vs. 2.2 mm, p = 0.015). After removal of outliers, regression analysis revealed no linear relationship between BMI and subsidence (p = 0.35), but planned stem size was significantly correlated with subsidence (p = 0.005). Moreover, patients with obesity and larger planned stem sizes experienced greater subsidence. Clinical outcomes improved significantly in both groups. Conclusions: Obesity is associated with increased subsidence in short-stem THA, particularly in patients with larger planned stem sizes. Although BMI alone may not predict subsidence, careful selection of stem size and precise imaging techniques are crucial for minimizing subsidence risk in patients with obesity.
AB - Background: Short-stem total hip arthroplasty (THA) has gained popularity due to its bone-sparing technique, but its outcomes in patients with obesity remain uncertain. The aim of this study was to investigate the impact of obesity on postoperative subsidence and clinical outcomes after short-stem THA. Methods: A retrospective cohort study with a minimum follow-up of 24 months was conducted on 163 patients who underwent short-stem THA with a collarless, triple-tapered, cementless stem achieving fixation in the metaphyseal region. Patients were categorized into obesity (Body Mass Index, BMI ≥ 30 kg/m2) and nonobesity (BMI < 30 kg/m2) groups. Subsidence rates, clinical outcomes, and complications were analyzed to assess the influence of BMI on the outcome of short stem THA. Regression analysis was performed to assess the influence of the independent variables (BMI, stem size, deviation from planning) on subsidence. Results: The obesity group (mean follow-up 58.6 months) exhibited significantly greater subsidence rates than did the nonobesity group (mean follow-up 38.9 months; 2.6 mm vs. 2.2 mm, p = 0.015). After removal of outliers, regression analysis revealed no linear relationship between BMI and subsidence (p = 0.35), but planned stem size was significantly correlated with subsidence (p = 0.005). Moreover, patients with obesity and larger planned stem sizes experienced greater subsidence. Clinical outcomes improved significantly in both groups. Conclusions: Obesity is associated with increased subsidence in short-stem THA, particularly in patients with larger planned stem sizes. Although BMI alone may not predict subsidence, careful selection of stem size and precise imaging techniques are crucial for minimizing subsidence risk in patients with obesity.
KW - clinical outcomes in hip arthroplasty
KW - obesity and THA
KW - postoperative subsidence in THA
KW - short-stem total hip arthroplasty (THA)
KW - stem size and subsidence correlation
UR - http://www.scopus.com/inward/record.url?scp=85213284371&partnerID=8YFLogxK
U2 - 10.3390/jcm13247596
DO - 10.3390/jcm13247596
M3 - Article
AN - SCOPUS:85213284371
SN - 2077-0383
VL - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 24
M1 - 7596
ER -