No abstract

Level IV therapeutic, retrospective, cohort study.

Total hip arthroplasty (THA) is a very satisfactory surgical procedure for end-stage hip disorders.Implant modifications, such as large femoral heads to improve stability, porous metals to enhance fixation and alternative bearings to improve wear, have been introduced over the last decade in order to decrease the rate of early and late failures.There is a changing pattern of THA failure modes.The relationship between failure modes and patient-related factors, and the time and type of revision are important for understanding and preventing short and late failure of implants.The early adoption of innovations in either technique or implant design may lead to an increased risk of early failure.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170068

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.