A Single Femoral Component for All Total Hip Replacements Performed by a Trust? Does This Affect Early Clinical and Radiological Outcomes?

Abstract

Background: Hospitals may be under pressure to implement cost saving strategies regarding prosthesis choice. This<br />may involve the use of components which are not the first preference of individual surgeons, or those they have little<br />experience with. We aim to examine the effect of standardizing the type of femoral stem used in a single trust, and<br />determine whether this is safe practice, particularly in those who have never used this particular stem before.<br />Methods: We report results at 2 years of 151 primary total hip arthroplasties performed using a single femoral stem.<br />Data was split into 2 groups: those in which the operating surgeon was previously using this femoral stem, and those<br />who were not. Radiographic outcomes measured were leg length discrepancy, cement mantle grade, and femoral stem<br />alignment. We also report on clinical outcomes, complications, and construct survivability.<br />Results: No significant differences in clinical outcomes were observed. Cement quality was generally worse in those<br />with no prior use of this stem. Leg length inequality was greater in those previously using the stem (+1.57mm vs<br />3.83mm), however this did not correlate to clinical outcomes. Alignment was similar between the groups (P=0.464).<br />Conclusion: Our findings suggest that although clinical outcomes are similar at 2 years, radiological differences can<br />be observed even at this early stage in follow up. Choice of components for arthroplasty should remain surgeon led until<br />long term follow up studies can prove otherwise.