title: 10 years results of an uncemented metaphyseal fit modular stem in elderly patients.
abstract: BACKGROUND
  There are concerns with regard to the femoral fixation in cementless total hip arthroplasty in elderly patients. We report a retrospective analysis of clinical and radiological results of uncemented metaphyseal fit modular stem in elderly patients irrespective of anatomic characterstics of proximal femur.
  
  
  METHODS
  This study reviews the outcomes of 60 primary hip replacements using a metaphyseal fit modular stem (third-generation Omniflex stem) conducted in 54 patients, of age 75 years or older. After a mean follow-up of 10,4 years, complete clinical and radiographic records were available for 52 hips of 48 patients. The patients were evaluated by Harris Hip Score (HHS).
  
  
  RESULTS
  There was a significantly improved pain score and Harris Hip Score (41,6 to 83,2). Six stems (11.53%) were revised: four because of periprosthetic fracture; one stem was well fixed, but presented a large osteolytic lesion in the metaphyseal area and the last stem was revised because of aseptic loosening. Stem survival taking aseptic loosening as the end-point was 98%. Bone atrophy in the proximal femur caused by stress shielding was observed in 39 stems (75%), but there was no case of subtrochanteric stress shielding. Moreover, atrophy appeared within two years postoperatively, with no extension thereafter.
  
  
  CONCLUSIONS
  We achieved good clinical and radiographic results by uncemented metaphyseal fit femoral stem regardless of patient's age and femoral canal type.
authors.affiliation: Department of Orthopedic Surgery, University Hospital of Guadalajara, Alcala University, Guadalajara.
authors.forename: Basilio J
authors.initials: BJ
authors.lastname: De la Torre
authors.forename: Manuel
authors.initials: M
authors.lastname: Chaparro
authors.forename: Juan O
authors.initials: JO
authors.lastname: Romanillos
authors.forename: Sara
authors.initials: S
authors.lastname: Zarzoso
authors.forename: Margarita
authors.initials: M
authors.lastname: Mosquera
authors.forename: Gil
authors.initials: G
authors.lastname: Rodriguez