Twenty-year results of a neck-preserving short-stem prosthesis in primary total hip arthroplasty

Purpose The use of short-stemmed femoral components with preservation of the femoral neck has been advocated for younger and more active patients undergoing joint replacement. This study reports the long-term outcomes of the Collum Femoris-Preserving (CFP) prosthesis on a previous report. Methods Between January 1999 and December 2000, a total of 149 patients underwent total hip arthroplasty procedure using the CFP stem in a single institution. At latest follow-up, 79 patients were available and were included in this study. The mean age of the cohort was 73.4 (range, 44–92 years) with a mean follow-up of 20.7 years (range 20–21). The average age was 52.1 years at index procedure (range, 21–71 years). Results The Kaplan–Meier survivorship free from revision for any cause at 5, 10 and 20 years was 93.2% (87.8–96.3%), 93.2% (87.8–96.3%) and 83.0% (75.7–88.3%), respectively. At 20 years follow-up, the revision for any cause occurred in 26.6% (21 of 79) of patients. The most common causes for revision surgery were aseptic loosening, dislocation, and polyethylene wear with 6.3% (5 out of 79), respectively. Periprosthetic fracture occurred in four patients (5.1%) followed by periprosthetic joint infection in two patients (2.5%). Revision surgery of the femoral stem was required in four patients (5.1%). There was a statistically significant improvement of the Harris Hip Scores from 53 to 83.7 (range 56–91). Conclusion The long-term outcomes of the CFP stem are excellent, demonstrating a low rate of aseptic loosening with an excellent survivorship within 2 decades.