A Randomized Controlled Trial of Short Versus Standard Exeter V40 Stems in Total Hip Arthroplasty: Can Arthroplasty Stem Influence Outcome (CASINO)?

Description

In a presentation led by Paul Gaston, the speaker discusses the workings and findings of the Casino trial, a randomized controlled study exploring the effectiveness of the new Exeter short stem prosthesis for hip arthroplasty. Gaston mentions the absence of Nicholas Clément, who is currently in Mallorca, and thanks the Association for the chance to present. The trial set out to examine the functional outcomes associated with short stems compared to standard length stems, given the rising demographics of younger patients with anatomical challenges that hinder traditional implantation methods. The trial was double-blinded and aimed at determining whether patients would experience any detriment from receiving the shorter stems, while also measuring various other health and recovery metrics.



Gaston highlights that short stems are increasingly prevalent in total hip replacement surgery but have shown varying degrees of success in clinical settings, prompting the need for this trial. Initial results indicated no significant differences in functional outcomes between short and standard stem patients at one and two-year follow-ups, suggesting that the use of short stems does not negatively impact patient satisfaction or health outcomes.



However, the study also revealed a higher incidence of varus malalignment in the short stem group, raising questions about the long-term effects of this alignment issue on implant survivorship. In conclusion, Gaston asserts that short stem Exeter implants provide equivalent short-term results to traditional options, though monitoring for potential long-term impacts remains necessary.

DOI: 10.1302/3114-230342

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