title: Comparing the long-term results of two uncemented femoral stems for total hip arthroplasty.
abstract: 327 proximal and 185 extensively coated femoral stems with mean 10-year follow-up were reviewed. Implant survivorship, clinical outcomes, and radiographic analyses were compared. Kaplan-Meier implant survivorship was 97.5% for the proximal, and 98.8% for the extensively coated stem for stem-only revisions at 10-years. The proximally coated stem outperformed on the PCS arm of the SF-12 (P = 0.04) and stiffness arm of the WOMAC (P = 0.03). Otherwise, all clinical outcomes were comparable. Thigh pain incidence was 12.5% and 5.3% for the extensive versus proximally coated groups, respectively (P = 0.007). Radiographic review identified more severe stress shielding (P < 0.001) in the extensively coated stems. This study supports the long-term clinical track record of total hip arthroplasty using two different cementless stem designs.
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Center, University Hospital, London, Ontario, Canada.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Petis
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Center, University Hospital, London, Ontario, Canada.
authors.forename: James L
authors.initials: JL
authors.lastname: Howard
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Center, University Hospital, London, Ontario, Canada.
authors.forename: James P
authors.initials: JP
authors.lastname: McAuley
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Center, University Hospital, London, Ontario, Canada.
authors.forename: Lyndsay
authors.initials: L
authors.lastname: Somerville
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Center, University Hospital, London, Ontario, Canada.
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCalden
authors.affiliation: Division of Orthopedic Surgery, London Health Sciences Center, University Hospital, London, Ontario, Canada.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: MacDonald
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D015992:Body Mass Index; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: arthroplasty; cementless; extensively coated; hip; proximally coated