title: Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem: 5- to 16-year results of 163 cases.
abstract: OBJECTIVE
  Due to the relative lack of reports on the medium- to long-term clinical and radiographic results of modular femoral cementless revision, we conducted this study to evaluate the medium- to long-term results of uncemented femoral stem revisions using the modular MRP-TITAN stem with distal diaphyseal fixation in a consecutive patient series.
  
  
  METHODS
  We retrospectively analyzed 163 femoral stem revisions performed between 1993 and 2001 with a mean follow-up of 10 (5-16) years. Clinical assessment included the Harris hip score (HHS) with reference to comorbidities and femoral defect sizes classified by Charnley and Paprosky. Intraoperative and postoperative complications were analyzed and the failure rate of the MRP stem for any reason was examined.
  
  
  RESULTS
  Mean HHS improved up to the last follow-up (37 (SD 24) vs. 79 (SD 19); p<0.001). 99 cases (61%) had extensive bone defects (Paprosky IIB-III). Radiographic evaluation showed stable stem anchorage in 151 cases (93%) at the last follow-up. 10 implants (6%) failed for various reasons. Neither a breakage of a stem nor loosening of the morse taper junction was recorded. Kaplan-Meier survival analysis revealed a 10-year survival probability of 97% (95% CI: 95-100).
  
  
  CONCLUSIONS
  This is one of the largest medium- to long-term analyses of cementless modular revision stems with distal diaphyseal anchorage. The modular MRP-TITAN was reliable, with a Kaplan-Meier survival probability of 97% at 10 years.
authors.affiliation: Department of Orthopaedic and Trauma Surgery , University Hospital Bonn , Bonn.
authors.forename: Dieter C
authors.initials: DC
authors.lastname: Wirtz
authors.forename: Sascha
authors.initials: S
authors.lastname: Gravius
authors.forename: Rudolf
authors.initials: R
authors.lastname: Ascherl
authors.forename: Miguel
authors.initials: M
authors.lastname: Thorweihe
authors.forename: Raimund
authors.initials: R
authors.lastname: Forst
authors.forename: Ulrich
authors.initials: U
authors.lastname: Noeth
authors.forename: Uwe M
authors.initials: UM
authors.lastname: Maus
authors.forename: Matthias D
authors.initials: MD
authors.lastname: Wimmer
authors.forename: Günther
authors.initials: G
authors.lastname: Zeiler
authors.forename: Moritz C
authors.initials: MC
authors.lastname: Deml
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D002484:Cementation; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011475:Prosthesis Failure / Q000209:etiology; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D014025:Titanium
chemical_list: D014025:Titanium