A Single Femoral Component for All Total Hip Replacements Performed by a Trust? Does This Affect Early Clinical and Radiological Outcomes?

Background: Hospitals may be under pressure to implement cost saving strategies regarding prosthesis choice. Thismay involve the use of components which are not the first preference of individual surgeons, or those they have littleexperience with. We aim to examine the effect of standardizing the type of femoral stem used in a single trust, anddetermine whether this is safe practice, particularly in those who have never used this particular stem before.Methods: We report results at 2 years of 151 primary total hip arthroplasties performed using a single femoral stem.Data was split into 2 groups: those in which the operating surgeon was previously using this femoral stem, and thosewho were not. Radiographic outcomes measured were leg length discrepancy, cement mantle grade, and femoral stemalignment. We also report on clinical outcomes, complications, and construct survivability.Results: No significant differences in clinical outcomes were observed. Cement quality was generally worse in thosewith no prior use of this stem. Leg length inequality was greater in those previously using the stem (+1.57mm vs3.83mm), however this did not correlate to clinical outcomes. Alignment was similar between the groups (P=0.464).Conclusion: Our findings suggest that although clinical outcomes are similar at 2 years, radiological differences canbe observed even at this early stage in follow up. Choice of components for arthroplasty should remain surgeon led untillong term follow up studies can prove otherwise.