title: Triple taper polished cemented stem in total hip arthroplasty: rationale for the design, surgical technique, and 7 years of clinical experience.
abstract: Successful long-term clinical results with the Charnley low-friction torque arthroplasty have identified proximal femoral strain shielding as a long-term problem to be addressed. The problem has arisen because of the load transfer by a distally supported stem that is no longer subject to fracture. To overcome this problem and improve proximal load transfer to the femur, a continuous triple-tapered stem--the C stem--was designed. This article describes the first 500 primary hip arthroplasties at a mean follow-up of 3 years, 5 months (range, 1-7 years). There have been no revisions for aseptic stem loosening, and no stem is considered to be at risk for loosening. In 20% of cases, there was subjective radiologic improvement of the bone-cement interface.
authors.affiliation: Department of Orthopaedic Biomechanics, The John Charnley Research Institute, Wrightington Hospital, Nr. Wigan, United Kingdom.
authors.forename: B M
authors.initials: BM
authors.lastname: Wroblewski
authors.forename: P D
authors.initials: PD
authors.lastname: Siney
authors.forename: P A
authors.initials: PA
authors.lastname: Fleming
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome