Short stem prosthesis
Synonyms in a broader sense
Short shaft prosthesis, Cut prosthesis, Mayo prosthesis, Metha prosthesis, artificial hip joint, Hip prosthesis, coxarthrosis, coxarthrosis
English: short stem prosthesis
definition
As part of the technical development in orthopedics, more and more prosthesis models are being developed with the aim of removing as little bone material as possible during hip surgery in order to find good conditions for a possible replacement operation to be able to safely anchor a new prosthesis again. In addition to the cap prosthesis (McMinn prosthesis), the short shaft prosthesis is suitable for bone-saving implantation.
The operation of the short stem prosthesis
The operation to insert a short stem prosthesis usually takes place under general or partial anesthesia (Spinal anesthesia) instead of.
Access to the hip is preferably selected via a tissue-sparing, minimally invasive approach, whereby the skin incision is made over the lateral hip joint (anterolateral approach) so that a severance of hip muscles or tendons is avoided.
This results in less postoperative pain, fewer complications and faster rehabilitation.
Once the hip joint is exposed, the femoral head is first removed, the hip joint socket milled out and then replaced with an artificial one. The prosthetic stem is then inserted into the femur, attached and provided with an artificial femoral head. Short-stem prostheses are cemented without cement, so that they are initially "only" inserted or clamped into the still intact thigh bone and gain further stability over the next few weeks as bone tissue grows into the roughened prosthesis surface. To ensure that the short-shaft prosthesis has been inserted correctly, an X-ray image is taken in the operating room before the wound is closed, on which the correct fit of the prosthesis can be checked.
Read more on the topic: Hip prosthesis surgery
implication
A short-shaft prosthesis can be implanted “minimally invasively”.
This means that it is implanted through a small 6-10 cm incision in the skin. The muscles can be spared as much as possible. The operation is carried out as was a cementless implantation Hip replacement.
Prosthesis design
A short-shaft prosthesis is a cement-free hip prosthesis which, compared to a “classic prosthesis”, has a prosthesis shaft that is about 2/3 shorter.
The prosthesis is anchored in the upper part of the thigh bone (femur).
The acetabulum is implanted normally. As a rule, every hip socket can be combined with a short-stem prosthesis.
Appointment with a hip expert?
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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Directly to the online appointment arrangement
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Further information about myself can be found at Dr. Nicolas Gumpert
Age
Who is this hip prosthesis particularly suitable for?
Due to the special prosthesis design of a short-shaft prosthesis, it can be implanted to save bone. The bone in the shaft of the thigh bone (femur) remains unchanged during this operation.
Especially young people who have a artificial hip joint must be implanted, have to reckon with a replacement operation. Therefore, the Short stem prosthesis, like the one in the McMinn prosthesis (cap prosthesis), for young people.
Aftercare
The follow-up treatment of a short stem prosthesis is usually comparable to that of a cementless prosthesis.
Normally, a partial load of two to four weeks has to be overcome after the implantation. During this time, some of the stress when walking over walking sticks has to be absorbed.
Contraindication
Since the short-stem prosthesis (Mayo prosthesis) is only anchored via a very short stem, optimal bone quality is an essential requirement for the implantation of this prosthetic model.
Contraindications to implantation are therefore:
- Osteoporosis (bone decalcification)
- atypically shaped Femoral neck (varic or valgic femoral neck = femoral neck with too much or too little bend)
Advantages and disadvantages of short stem prosthesis
Advantage of the short stem prosthesis:
The main advantage of a short-shaft prosthesis is that, thanks to the shorter shaft of the implant, less of the femoral neck bone has to be hollowed out in order to be able to subsequently insert the prosthesis.
Accordingly, a larger proportion of the femur remains intact and preserved, so that it corresponds functionally and anatomically to the original, healthy femur neck bone. These are ideal conditions in the event that a new one surgery is necessary to change the prosthesis. This means that the bone-saving short-shaft prostheses are particularly suitable for younger patients, for whom a replacement of the prosthesis will be necessary and likely after around 20 years due to age and normal prosthesis wear.
Disadvantage of the short-stem prosthesis:
A disadvantage of short-stem prostheses is the cement-free implantation. The process of "Ingrowth“Can sometimes lead to problems and the time it takes to fully load the hip joint is usually longer than with cementation. In the stabilization phase of the ingrowth, symptoms such as stress and / or bone pain can occasionally occur; in rare cases, ingrowth and thus also the bone stability can be completely absent, so that another operation and a change to a different prosthesis model is inevitable.
Risks
The risks of this prosthesis are essentially no different from those of a cementless prosthesis.
The risks of hip replacement surgery are discussed in our chapter:
Complications of hip replacement surgery are described.
Frequency / outlook
Short-stem prostheses have only been implanted for a few years. Most of the long-term information currently exists on the Mayo short-stem prosthesis.
The short-stem prosthesis is implanted more and more frequently, so that a lot of information about the durability and complication rate will be available within the next few years.
The first results of this type of prosthesis are very promising. In the functional follow-up examination, customer prostheses perform about as well as classic cementless prostheses.
If they have been selected for the “right” patient, they appear more suitable for the younger patient, given the more favorable conditions for a replacement operation.
The next few years will show whether short-shaft prostheses or McMinn prostheses (cap prostheses) will prevail.
