Clinical Orthopaedics and Related Research®

, Volume 468, Issue 2, pp 441–447 | Cite as

High Survival of Uncemented Proximally Porous-coated Titanium Alloy Femoral Stems in Osteoporotic Bone

  • John B. Meding
  • Matthew R. Galley
  • Merrill A. Ritter
Symposium: Papers Presented at the Hip Society Meetings 2009

Abstract

Because the initial fixation of an uncemented stem may be compromised in patients with osteoporotic bone (Class C, Dorr et al.), many surgeons prefer a cemented stem in this setting. We therefore determined the survival of an uncemented, proximally porous-coated, straight-stemmed, titanium alloy femoral component in patients with Class C bone when compared with Class A and B bone. We implanted proximally plasma-sprayed, straight-stemmed titanium alloy stems in 1994 patients (2321 hips). Of these, 625 hips (27%), 1569 hips (67%), and 127 hips (6%) were classified as Classes A, B, and C, respectively. Minimum followup was 2 years (mean, 5.9 years; range, 2–19.5 years). We identified no differences in Harris hip scores, pain, radiolucencies, or osteolysis among Classes A, B, and C hips. Stem survival at 5, 10, and 15 years for aseptic loosening (failure) was 100% in all patients with Class A bone; 99+% in all patients with Class B bone; and 100% in all patients with Class C bone. Initial stability and durable fixation can be achieved with the use of this uncemented stem in patients in whom a cemented stem traditionally has been preferred as a result of poor bone quality.

Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Notes

Acknowledgments

We thank Dr Michael E. Berend, Dr Robert A. Malinzak, Dr E. Michael Keating, Dr Philip M. Faris, and Matthew J. Brunsman, MS, for their assistance.

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Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  • John B. Meding
    • 1
  • Matthew R. Galley
    • 1
  • Merrill A. Ritter
    • 1
  1. 1.The Center for Hip and Knee SurgerySt Francis Hospital, MooresvilleMooresvilleUSA

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