Are old age and being very overweight still contraindications for the short shaft?

In our latest video we go together with Dr. Thorsten Hillmann, Eduardus Hospital Cologne, asked the question of how the short shaft can be used in the very old and in people with obesity. Dr. has both previous contraindications. Hillmann examined in detail with his colleagues at the Eduardus Hospital in Cologne.

In people with obesity, the Cologne researchers compared the cement-free short stem treatment in n=130 patients with a body mass index (BMI) of ≥ 40 kg/m2 and n=120 patients with a BMI of 20-29.9 kg/m2. The obese patients were, on average, younger and in poorer physical condition during the operation, and the operations took significantly longer. It is known that people with obesity suffer more complications and the risk of dislocation is also higher, regardless of the implant. The Cologne results showed no fractures in the two groups and no differences in the scores (Oxford Hip Score, “Cologne-Deutz Score”).

For Dr. According to Hillmann, bone quality is the decisive criterion. If the bone substance is good (Dorr types A and B), almost all active patients could be treated with a short stem. In Dorr type C – with manifest osteoporosis or very poor bone quality – there is a contraindication to the cement-free short stem. However, since the introduction of the cemented A2 short stem, there has been a bone-saving and minimally invasive solution in many cases.