Femoral neck prostheses: A systematic analysis of the literature

Primary total hip arthroplasty (THA) is one of the most successful surgical procedures. Considering the demographic change the use of new ultra-short femoral implants has gained importance especially when treating young patients. Main features are bone conservation, metaphyseal anchoring and thus reducing stress shielding by proximal load transferring. The objective of this study is to give an overview over the subject of femoral neck prostheses. A systematic review was conducted. A total number of 27 publications were taken into this systematic review. Over all, just a few follow-up, biomechanical and radiostereometric studies have been conducted in the past. Still no long-term results (>10 years of follow-up) are available. The available mid-term results indicate unsatisfactory survival rates. Aseptic loosening was the most common reason for revision. Valgus angle and good bone mineral density were considered to be crucial for primary stability of femoral neck prostheses. Register data report a very low percentage of femoral neck prostheses in THA with even more diminishing implantation rates. To conclude, further studies are necessary in order to provide evidence-based recommendations. Currently, due to the inhomogeneous and poor data a reasonable and legitimate recommendation cannot be given.