title: Minimum 10-Year Follow-Up of Cementless Total Hip Arthroplasty Using a Contemporary Triple-Tapered Titanium Stem.
abstract: There is extensive variation in design and insertion technique of cementless tapered femoral stems. The purpose of our study was to evaluate a consecutive series of contemporary tapered cementless femoral stems inserted with a ream-and-broach technique at a minimum 10-year follow-up in patients undergoing total hip arthroplasty (THA).
  
  
  
  One hundred consecutive THAs (88 patients) performed by a single surgeon were followed for a minimum of 10 years. Hips were evaluated clinically for revision status, Western Ontario and McMaster Universities Osteoarthritis Index, 36-item Short Form Health Survey, Harris Hip Score, and University of California, Los Angeles, and Tegner Activity Scores. Radiographic evaluation included assessment for loosening, osteolysis, and stress shielding. Kaplan-Meier survivorship analysis included end points for revision and radiographic evidence of femoral component loosening.
  
  
  
  At minimum 10-year follow-up, 66 patients (74 hips) were living, 20 patients (24 hips) were deceased, and 2 patients (2 hips) were lost to follow-up. Four hips required reoperation, but no femoral components were revised for aseptic loosening. One femoral component (1%) was revised due to a postoperative periprosthetic fracture. Radiographic evaluation demonstrated bone ingrowth of all stems without evidence of component loosening and 1 case of severe stress shielding. Kaplan-Meier survivorship at 10 years was 100% for the end points of femoral revision for loosening or femoral radiographic loosening.
  
  
  
  This contemporary, cementless titanium-tapered femoral component inserted with ream-and-broach technique demonstrated excellent results in terms of outcomes and clinical durability as well as osteointegration on radiographs at minimum 10-year follow-up. This study corroborates, with level 2 and level 3 data, level 1 data reported in national registries.
authors.affiliation: Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Samuel W
authors.initials: SW
authors.lastname: Carlson
authors.affiliation: Des Moines Orthopaedic Surgeons, West Des Moines, Iowa.
authors.forename: Devon D
authors.initials: DD
authors.lastname: Goetz
authors.affiliation: Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Steve S
authors.initials: SS
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Greiner
authors.affiliation: Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: John J
authors.initials: JJ
authors.lastname: Callaghan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000706:statistics & numerical data; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium
keywords: cementless total hip arthroplasty; primary total hip arthroplasty; ream-and-broach; tapered stem