Good survival of uncemented tapered stems for failed intertrochanteric osteotomy: a mean 16 year follow-up study in 45 patients.
BACKGROUND
Inferior survival of cemented total hip arthroplasty has been reported after previous femoral osteotomy. We previously presented 5-15 years results of uncemented femoral stems for this subgroup of patients. The purpose of the present study was to re-evaluate that same patient group at 10-20 years follow-up.


METHODS
Forty-eight hips in 45 patients had undergone conversion THA for a failed intertrochanteric osteotomy of the hip after a mean of 12 years (2-33 years). Mean time of follow-up was 16 years (10-20 years).


RESULTS
At the latest follow-up five patients had died (five hips), and one patient (one hip) remained lost to follow-up. Compared to the previous evaluation, one more patient required femoral revision for aseptic loosening giving a total of four patients (four hips) with femoral revision--one for infection and three for aseptic loosening of the stem. Survival of the stem was 91% at 15 and 20 years respectively; survival with femoral revision for aseptic loosening as an end point was 93%. The median Harris-Hip-Score at final follow-up was 76 points (previously 80 points). Radiolucent lines in Gruen zones 1 and 7 were present in 20 and 17% of hips, respectively. Radiolucencies in other zones were not detected. There was no radiographic evidence of femoral osteolysis, stress-shielding or loosening.


CONCLUSIONS
The long-term results with this type of uncemented tapered titanium femoral component after proximal femoral osteotomy remain encouraging and compare favorably to those achieved in patients with regular femoral anatomy.
Parsch
Dominik
D
Stiftung Orthopädische Universitätsklinik, Heidelberg, Germany.
Jung
Alexander W
AW
Thomsen
Marc
M
Ewerbeck
Volker
V
Aldinger
Peter R
PR
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome
D001843:Bone Cements