title: Second-generation proximally coated titanium femoral component: minimum 7-year results.
abstract: It is unclear whether resurfacing or fully porous-coated or proximally coated stems are the best femoral components for young patients. First-generation proximally coated titanium fiber-metal femoral components had a high rate of failure. We prospectively followed 56 patients (70 hips) whom we believed were at high risk for loosening of a cemented femoral component; all patients were implanted with one second-generation proximally coated titanium femoral component. Ten patients (11 hips) died and three patients (four hips) were lost to minimum followup. Three models of titanium fiber-metal acetabular component were implanted with screws. Patients were clinically evaluated using the Harris hip score. We used standardized radiographs to assess fixation status and osteolysis. Forty-four patients (55 hips) with a mean age of 45 years were followed for a minimum of 7 years (mean, 10.5 years; range, 7-15 years). No femoral component had been revised for any reason. Bone ingrowth (spot welding) was seen in 41 hips (75%) and proximal femoral osteolysis in only four hips. Reoperations for polyethylene wear were performed in seven patients (12.7%) and two patients had liner exchange for recurrent dislocation. Even with an articulating surface with considerable polyethylene wear debris, these second-generation proximally coated titanium fiber-metal femoral components had a survival rate of 100% at a mean 10.5-year followup.
authors.affiliation: Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. paul_lachiewicz@med.unc.edu
authors.forename: Paul F
authors.initials: PF
authors.lastname: Lachiewicz
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Soileau
authors.forename: Paul
authors.initials: P
authors.lastname: Bryant
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D016348:Osseointegration; D010014:Osteolysis / Q000209:etiology; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium