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Retrospective cohort study compares short-term outcomes in hip arthroplasty using two femoral stems, revealing important implications for implant choice.
Background and Objective Standard-length hydroxyapatite (HA)-coated femoral stems have demonstrated strong performance and survivorship in total hip arthroplasty. However, limited data exist comparing these outcomes to those of newer, shortened HA-coated stems. Materials and Methods: This retrospective cohort study evaluated intraoperative and postoperative outcomes in patients who underwent total hip arthroplasty using either the standard-length Origin Stem or the shortened Alteon HA Femoral Stem. Results: A total of 479 patients were included (151 Origin, 328 Alteon HA). The Origin group showed higher rates of calcar fracture (3.3% vs 2.1%), distal femur reaming (2.0% vs 0.3%), and revision (1.3% vs 0.3%), though not statistically significant. Osseointegration was achieved in the majority of cases (Origin: 96.8%; Alteon HA: 95.0%). Both groups experienced significant improvements in Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR) and EQ-5D scores ( P < .0001), as well as having comparable Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 scores. Leg length discrepancy occurred significantly more frequently in the Origin group compared to the Alteon HA group (2.6% vs 0.3%). The Alteon HA group demonstrated a 2-year survivorship rate of 98.2%. Conclusion: Both the standard-length Origin and shortened Alteon HA stems showed excellent short-term results, with 96% of patients in each group experiencing meaningful functional improvement. Both implants showed high osseointegration with low complication and revision rates. The Origin stem required more distal reaming and had an increased leg length discrepancy risk, whereas the shorter Alteon HA stem provided greater intraoperative flexibility with equally strong early results.
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Christensen et al. (2026) studied this question.
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