Clinical Orthopaedics and Related Research®

, Volume 470, Issue 11, pp 3024–3031

Femoral Bone Is Preserved Using Cemented Polished Stems in Young Patients

  • Donald W. Howie
  • Kerry Costi
  • Margaret A. McGee
  • Angela Standen
  • Lucian B. Solomon
Symposium: Papers Presented at the 2011 Meeting of the International Hip Society

DOI: 10.1007/s11999-012-2327-2

Cite this article as:
Howie, D.W., Costi, K., McGee, M.A. et al. Clin Orthop Relat Res (2012) 470: 3024. doi:10.1007/s11999-012-2327-2

Abstract

Background

Techniques that ensure femoral bone preservation after primary THA are important in younger patients who are likely to undergo revision surgery.

Questions/purposes

We examined femoral stem survival, bone deficiency at revision arthroplasty, and radiographic bone loss in hips implanted with a cemented polished double-taper stem in a cohort of patients younger than 55 years.

Methods

We reviewed 197 hips (median patient age, 47 years; range, 16–54 years) after a minimum followup of 2 years (median, 7 years; range, 2–19 years) since primary THA. Clinically, we determined survival to major and minor stem revision and cases of bone deficiency requiring a long stem or impaction bone grafting or created by the need for femoral osteotomy at revision arthroplasty. Radiographically, we assessed stem loosening, femoral osteolysis, and femoral bone deficiency.

Results

Stem survival to major revision for aseptic loosening was 100% at 13 years and for any reason was 97% (95% CI, 93–100%). At revision of seven stems, a long stem was used in one hip, a total femoral replacement in one hip and impaction bone grafting in one hip. No femoral osteotomies were required. Bone was preserved in four hips by cement-within-cement stem exchange. No stems were radiographically loose. Proximal osteolysis was present in 11% of femurs. Femoral bone deficiency was graded as Paprosky Type I (97%) or II (3%) and Endo-Klinik Grade 0 (79%) or I (21%).

Conclusions

Cemented polished taper stems have high survival at 13 years in young patients and enable femoral bone preservation for subsequent revision.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Donald W. Howie
    • 1
    • 2
  • Kerry Costi
    • 1
  • Margaret A. McGee
    • 1
    • 2
  • Angela Standen
    • 1
  • Lucian B. Solomon
    • 1
    • 2
  1. 1.Department of Orthopaedics and TraumaRoyal Adelaide HospitalAdelaideAustralia
  2. 2.Discipline of Orthopaedics and Trauma, School of MedicineUniversity of AdelaideAdelaideAustralia

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