Survival and radioclinical evaluation of the Optimys™ short stem at more than 6years' mean follow-up: A retrospective study of 108 cases

Matthieu Gabrion; Simon Rattier; Emile Blondin; Audrey Michaud; Patrice Mertl; Antoine Gabrion

doi:10.1016/j.otsr.2022.103470

Survival and radioclinical evaluation of the Optimys™ short stem at more than 6years' mean follow-up: A retrospective study of 108 cases

Orthop Traumatol Surg Res. 2023 Feb;109(1):103470. doi: 10.1016/j.otsr.2022.103470. Epub 2022 Nov 4.

Authors

Matthieu Gabrion¹, Simon Rattier², Emile Blondin², Audrey Michaud³, Patrice Mertl⁴, Antoine Gabrion⁴

Affiliations

¹ Service de chirurgie orthopédique et traumatologie, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France. Electronic address: gabrion.matthieu@chu-amiens.fr.
² Service de chirurgie orthopédique et traumatologie, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France.
³ Direction de la recherche clinique et de l'innovation, site Sud - Hall 1 - 1(er) étage zone administrative, 1, rond-point du Professeur-Christian-Cabrol, 80054 Amiens, France.
⁴ Service de chirurgie orthopédique et traumatologie, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France; UFR de médecine, pôle santé, 3, rue des Louvels, CS 13036, 80036 Amiens, France.

PMID: 36336294
DOI: 10.1016/j.otsr.2022.103470

Abstract

Introduction: The short stems developed in recent years offer an interesting alternative to standard long stems. The Optimys™ short stem has been widely studied, but not according to the National Institute for Health and Care Excellence (NICE) criteria. We therefore conducted a retrospective study of Optimys™ at a minimum 5years' follow-up, to assess: (1) survival on NICE criteria, (2) complications, (3) functional results, and (4) subsidence, restoration of offset and bone remodeling.

Hypothesis: Optimys™ shows survival comparable to that of other non-cemented standard and short stems, with a<0.5% per year revision rate or<2.5% at 5years on NICE criteria.

Material and methods: A single-center retrospective study included 108 Optimys™ stems at a mean 76.5months' follow-up (range: 60-112months). Clinical [Harris, Oxford-12 and forgotten hip (French version: SHO-12) scores] and radiologic data were collected pre- and postoperatively. Analysis focused on implant survival, complications, functional results and radiological results (restoration of offset, bone remodeling, subsidence and osseointegration) and risk factors for stem migration.

Results: At a mean 76.5months' follow-up (range: 60-112months), Optimys™ survival was 97.7% (95% CI: 0.945-1). Oxford and Harris scores improved significantly: respectively, 16.1 vs. 44.7 [Δ=28.598; 95% CI: 27.410-29.785 (p<0.001)] and 45.3 vs. 95 [Δ=49.662; 95% CI: 47.442-51.882 (p<0.001)]. Mean forgotten hip score (SHO-12) at last follow-up was 82.7±19.6 (range: 35.4-100.0). There was 1 case of aseptic revision at 11months for femoral osseointegration defect. Mean subsidence was 1.64mm (range: 0-20.63mm); no predisposing factors could be identified. Femoral offset increased by a mean 2.41±4.53mm (range: -10.10 to 14.70mm).

Conclusion: The present study reports good survival for the Optimys™ stem, which meets NICE criteria. Radiologic and clinical results were encouraging, with a low rate of subsidence, comparable to other series, but with increased femoral offset.

Level of evidence: IV; retrospective cohort study.

Keywords: Bone remodeling; Medium-term; Offset; Optimys™; Short stem; Subsidence; Survival; Total hip arthroplasty.

MeSH terms

Arthroplasty, Replacement, Hip* / methods
Follow-Up Studies
Hip Prosthesis* / adverse effects
Humans
Osseointegration
Prosthesis Design
Prosthesis Failure
Reoperation
Retrospective Studies