Minimum 2-Year Outcomes Of A Modern Monoblock Titanium Fluted Tapered Revision Stem For Complex Primary and Revision Total Hip Arthroplasty.

Journal: The Journal of arthroplasty

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Affiliated Institutions:  Clinical Fellow in Hip and Knee Adult Reconstruction, Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Director of Research, Associate Professor, Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Associate Professor, Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Professor of Surgery, Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Associate Professor of Surgery, Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. J.C. Kennedy Professor & Chairman, Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Professor of Surgery, Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada. Electronic address: richard.mccalden@lhsc.on.ca.

Abstract summary 

Modular titanium fluted tapered (TFT) stems have demonstrated excellent clinical success for femoral revision total hip arthroplasty (THA) surgery. This aim study reports the short-term outcomes of a novel modern monoblock TFT stem used for revision and complex primary THA with a minimum of 2 years of follow-up.We identified 126 patients who received a single monoblock TFT stem; 26 patients for complex THA (failed fracture fixation) and 100 patients for revision THA. The reasons for revision THA included 40 for previous periprosthetic joint infection (PJI), 42 for aseptic loosening, 9 for trunnionosis, and 9 for periprosthetic fractures. The Paprosky grading for femoral bone loss at the time of surgery and the measured subsidence of femoral stems at 3-month follow-up were determined. We evaluated the number and indications for re-operations.The mean time from surgery was 3.9 years (range, 2.0 to 6.9). A paired t-test analysis showed significant improvement from pre-operative versus post-operative clinical outcome scores (P < 0.001) for Harris Hip Score (38.76 +/- 15.24 versus 83.42 +/- 15.38), Western Ontario and McMaster Universities Arthritis Index (45.6 ± 19.0 versus 69.9 ± 21.3), Veterans RAND 12 Item Health Survey (VR12) Physical component (31.7 ± 8.1 versus 37.8 ± 11.3), and VR12 Mental component (48.2 ± 12.2 versus 51.6 ± 12.5). The Paprosky grading for femoral bone loss was Grade 1 (3.9%), Grade 2 (35.7%), Grade 3A (47.6%), Grade 3B (11.1%), and Grade 4 (1.6%) cases. There were 18 re-operations (14.7%), with 13 for PJI (7 treated with implant retention, 6 treated with a two-stage revision), 4 for instability, and one for acetabular aseptic loosening. There were no aseptic failures of the stem.This novel modern monoblock TFT stem provided reliable femoral fixation and has increasingly supplanted the use of modular TFT stems for complex primary and revision surgery in our institution.

Authors & Co-authors:  Alqahtani Somerville Vasharhelyi Howard Lanting Naudie MacDonald McCalden

Study Outcome 

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Statistics
Citations : 
Authors :  8
Identifiers
Doi : S0883-5403(24)00251-1
SSN : 1532-8406
Study Population
Male,Female
Mesh Terms
Other Terms
monoblock stems;outcomes;revision total hip arthroplasty;titanium fluted tapered stems
Study Design
Study Approach
Country of Study
Publication Country
United States