Minimum 10-Year Follow-Up of Cementless Total Hip Arthroplasty Using a Contemporary Triple-Tapered Titanium Stem

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• 作者：Samuel W. Carlson ; BA^a ; Devon D. Goetz ; MD^b ; Steve S. Liu ; MD^a ; Justin J. Greiner ; MD^a ; John J. Callaghan ; MD^a ;
• 关键词：primary total hip arthroplasty ; cementless total hip arthroplasty ; tapered stem ; ream-and-broach
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：31
• 期：10
• 页码：2231-2236
• 全文大小：785 K

文摘

There is extensive variation in design and insertion technique of cementless tapered femoral stems. The purpose of our study was to evaluate a consecutive series of contemporary tapered cementless femoral stems inserted with a ream-and-broach technique at a minimum 10-year follow-up in patients undergoing total hip arthroplasty (THA).

Methods

ra0015">One hundred consecutive THAs (88 patients) performed by a single surgeon were followed for a minimum of 10 years. Hips were evaluated clinically for revision status, Western Ontario and McMaster Universities Osteoarthritis Index, 36-item Short Form Health Survey, Harris Hip Score, and University of California, Los Angeles, and Tegner Activity Scores. Radiographic evaluation included assessment for loosening, osteolysis, and stress shielding. Kaplan–Meier survivorship analysis included end points for revision and radiographic evidence of femoral component loosening.

Results

ra0020">At minimum 10-year follow-up, 66 patients (74 hips) were living, 20 patients (24 hips) were deceased, and 2 patients (2 hips) were lost to follow-up. Four hips required reoperation, but no femoral components were revised for aseptic loosening. One femoral component (1%) was revised due to a postoperative periprosthetic fracture. Radiographic evaluation demonstrated bone ingrowth of all stems without evidence of component loosening and 1 case of severe stress shielding. Kaplan–Meier survivorship at 10 years was 100% for the end points of femoral revision for loosening or femoral radiographic loosening.

Conclusion

ra0025">This contemporary, cementless titanium-tapered femoral component inserted with ream-and-broach technique demonstrated excellent results in terms of outcomes and clinical durability as well as osteointegration on radiographs at minimum 10-year follow-up. This study corroborates, with level 2 and level 3 data, level 1 data reported in national registries.