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

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 NICE (National Institute for Health and Care Excellence) criteria. We therefore conducted a retrospective study of Optimys™ at a minimum 5 years' 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\texttrademark{} 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 5 years on NICE criteria. MATERIAL AND METHODS: A single-center retrospective study included 108 Optimys™ stems at a mean 76.5 months' follow-up (range, 60-112 months). Clinical (Harris, Oxford-12 and forgotten hip (French version: SHO-12) scores) and radiologic data were collected pre- and post-operatively. 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 76.5 months' follow-up (range, 60-112 months), Optimys™ survival was 97.7\% (95\%\,CI; 0.945-1). Oxford and Harris scores improved significantly: respectively, 16.1 vs 44.7 ({$\Delta$}= 28.598; 95\%\,CI: 27,410-29,785 (p{$<$}0.001)) and 45.3 vs 95 ({$\Delta$}= 49.662; 95\%\,CI: 47.442-51,882 (p{$<$}0.001)). Mean forgotten hip score (SHO-12) at last follow-up was 82.7 {$\pm$} 19.6 (range, 35.4-100.0). There was 1 case of aseptic revision at 11 months for femoral osseointegration defect. Mean subsidence was 1.64 mm (range, 0-20.63 mm); no predisposing factors could be identified. Femoral offset increased by a mean 2.41{$\pm$} 4.53 mm (range, -10.10\,to 14.70 mm). 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.
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Soumis le : mercredi 16 novembre 2022 - 18:32:54
Dernière modification le : mardi 6 décembre 2022 - 13:56:03




Matthieu Gabrion, Simon Rattier, Emile Blondin, Audrey Michaud, Patrice Mertl, et al.. Survival and radioclinical evaluation of the Optimys™ short stem at more than 6 years’ mean follow-up: a retrospective study of 108 cases. Orthopaedics & Traumatology: Surgery & Research, 2022, pp.103470. ⟨10.1016/j.otsr.2022.103470⟩. ⟨hal-03856582⟩



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