N°277 - October 2018
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Is a Short Stem an Option for Obese Patients?
By Sabine Mai, Werner Siebert in category REPORT
Clinique Orthopédique Vitos, Kassel, Allemagne
Obesity contributes to a higher rate of osteoarthritis in joints not only because of cartilage loading forces but also because the adipose tissue releases adipokine, a protein that leads to excess cartilage inflammation and degradation . Thus the risk to achieve osteoarthritis and to be in need of a total hip arthroplasty (THA) is up to 8.5 times higher than in non-obese patients .
The use of short stems in THA has increased over the last 10 years. There is a big variety of short stems that have different philosophies.
The benefits described are a more physiological load transfer to the proximal femur and preservation of bone. They enable soft tissue as well as muscle protection and facilitate minimally invasive implantation technique. The smaller implant-bone contact surface may cause inferior primary stability and be associated with higher migration rates compared to traditional stems. Biomechanical studies of the University in Ulm though could show that the stability is comparable to standard stems . The question is if a short stem is suitable also for obese patients.
Weight limits for implants are not often expressed by the manufacturer. Especially with short stems surgeons are skeptic to use them with heavy and obese patients. We...
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