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Femoral Revision Hip Arthroplasty: A Comparison of Two Stem Designs

  • Symposium: Papers Presented at the Hip Society Meetings 2009
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

For various reasons the tapered, fluted, modular titanium (TFMT) stem has become our component of choice over cylindrical, nonmodular cobalt chrome (CNCC) components for THA revision. We therefore asked whether the TFMT femoral components better achieved three important goals of revision arthroplasty than CNCC stems: (1) improving quality of life; (2) avoiding complications; and (3) preserving or restoring femoral bone stock. We compared patients undergoing femoral component revision hip arthroplasty with either a CNCC (N = 105) component or a TFMT (N = 95) component to determine if the increased use of TFMT components is justified. We retrospectively reviewed all patients undergoing revision total hip arthroplasty between January 2000 and March 2006. All eligible patients completed outcome questionnaires (WOMAC, SF-12, Oxford-12, UCLA Activity Score, and Satisfaction Scores). Radiographs were evaluated for loosening and preservation or restoration of the proximal femur host bone. The TFMT and CNCC cohorts were comparable with respect to age, gender, diagnosis, and comorbidities. The TFMT cohort had worse preoperative bone defects (65% Paprosky 3B and 4). The TFMT cohort had higher outcome scores (WOMAC pain, WOMAC stiffness, Oxford-12, and Satisfaction), fewer intraoperative fractures, and better restoration of the proximal femur host bone. Our data suggest the TFMT stem provided improved clinical outcomes (improved quality of life, decreased complications, and preservation of bone stock) than the CNCC stem.

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

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Acknowledgments

We thank Dr Nelson V. Greidanus for recruiting subjects in this study.

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Authors and Affiliations

  1. Division of Lower Limb Reconstruction and Oncology, Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, V5Z 4E3, Canada

    Corey J. Richards MD, MASc, FRCSC & Donald S. Garbuz MD, MHSc, FRCSC

  2. Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada

    Clive P. Duncan MD, MSc, FRCSC & Bassam A. Masri MD, FRCSC

Authors
  1. Corey J. Richards MD, MASc, FRCSC
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  2. Clive P. Duncan MD, MSc, FRCSC
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  3. Bassam A. Masri MD, FRCSC
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  4. Donald S. Garbuz MD, MHSc, FRCSC
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Corresponding author

Correspondence to Donald S. Garbuz MD, MHSc, FRCSC.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Richards, C.J., Duncan, C.P., Masri, B.A. et al. Femoral Revision Hip Arthroplasty: A Comparison of Two Stem Designs. Clin Orthop Relat Res 468, 491–496 (2010). https://doi.org/10.1007/s11999-009-1145-7

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  • DOI: https://doi.org/10.1007/s11999-009-1145-7

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