Q: I am a 72-year old avid tennis player and golfer but the pain in my right hip is really affecting my score in both games. I saw a surgeon who suggested trying a modified hip replacement using what he called a short-stem implant. But he didn't answer my question whether or not this type of hip replacement would get me back into action. What can you tell me?
A: Of course there's no guarantee after any surgery that everything will go exceedingly well. Surgeons are usually conservative in their recommendations after any implant surgery because studies often show a higher rate of implant failure with increased activity. Return to sports participation is a challenge and a very individual process.
That's where this short-stem implant comes in. Short-stem implants are just as the name implies. The long part of the implant referred to as the "stem" fits down inside the femur (thigh bone). The surgeon reams out bone inside the femur in order to set the stem down inside and stabilize the implant. With a short-stem implant, less bone is removed making it possible to consider revision surgery later if it is needed.
The surgery is performed with less invasive technique. This allows for less pain, better post-operative motion, faster healing, and a speedier recovery. And improvements made in the implant design also makes the procedure easier. Short-stem implantation is usually offered to younger patients (less than 55-years-old) who are in better physical condition before surgery. They tend to be able to begin rehab sooner and recover with fewer problems or complications.
But older adults (over the age of 65) who have good bone stock may be suitable candidates for this procedure. Studies show results are excellent with a high degree of patient satisfaction based on return-to-sports at a level desired by the patients. With more and more adults in need of hip replacement who want (and expect) to stay active, the short-stem implant is likely to be recommended more often now.
Reference: Florian Schmidutz, MD, MSc, et al. Sports Activity After Short-Stem Hip Arthroplasty. In The American Journal of Sports Medicine. February 2012. Vol. 40. No. 2. Pp. 425-432.
