title: Reproducible fixation with a tapered, fluted, modular, titanium stem in revision hip arthroplasty at 8-15 years follow-up.
abstract: The use of tapered, fluted, modular, distally fixing stems has increased in femoral revision surgery. The goal of this retrospective study was to assess mid-term to long-term outcomes of this implant. Seventy-one hips in 70 patients with a mean age of 69 years were followed for an average of 10 years. Preoperative HHS averaged 50 and improved to 87 postoperatively. Seventy-nine percent hips had Paprosky type 3A or more bone-loss. All stems osseointegrated distally (100%). Two hips subsided >5mm but achieved secondary stability. Sixty-eight percent hips had evidence of bony reconstitution and 21% demonstrated diaphyseal stress-shielding. One stem fractured near its modular junction and was revised with a mechanical failure rate of 1.4%. Distal fixation and clinical improvement were reproducibly achieved with this stem design.
authors.affiliation: North Shore LIJ Lenox Hill Hospital, New York, New York; Hospital For Special Surgery, New York, New York.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Rodriguez
authors.affiliation: VA Medical Center/NYU Hospitals Center, New York, New York. Electronic address: drajitdeshmukh@gmail.com.
authors.forename: Ajit J
authors.initials: AJ
authors.lastname: Deshmukh
authors.affiliation: North Shore LIJ Lenox Hill Hospital, New York, New York.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Robinson
authors.affiliation: Hospital For Special Surgery, New York, New York.
authors.forename: Charles N
authors.initials: CN
authors.lastname: Cornell
authors.affiliation: North Shore LIJ Health System, Great Neck, New York.
authors.forename: Vijay J
authors.initials: VJ
authors.lastname: Rasquinha
authors.affiliation: North Shore LIJ Lenox Hill Hospital, New York, New York; Hospital For Special Surgery, New York, New York.
authors.forename: Amar S
authors.initials: AS
authors.lastname: Ranawat
authors.affiliation: Hospital For Special Surgery, New York, New York.
authors.forename: Chitranjan S
authors.initials: CS
authors.lastname: Ranawat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D010147:Pain Measurement; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium
keywords: distal fixation; femoral bone loss; fluted; modular; revision hip arthroplasty; tapered; titanium stem