Clinical, radiographic, and survivorship analysis of a modular fluted tapered stem in revision hip arthroplasty

Abstract

Purpose: Modular fluted tapered stems are one of the most commonly used implants in femoral revision surgery. Due to the relative lack of studies on the Restoration modular fluted tapered stem, we conducted a study to evaluate its short- to mid-term clinical, radiographic, and survival outcomes. Methods: We identified all 45 patients treated with this revision stem at our institution. Five patients did not complete the minimum 2-year follow-up, leaving 40 patients (41 hips) for assessment. Mean follow-up was 5.1 years (range 2–11 years). Clinical outcomes were assessed using the Harris hip score (HHS). Radiographs were evaluated for subsidence and loosening. Kaplan–Meier survival analysis was performed using revision of the stem for any reason as end point. Results: The mean HHS improved from 44.6 points preoperatively to 78.4 points at the most recent follow-up ( p < 0.0001). Nonprogressive subsidence occurred in 83% of the hips (mean 2.8 mm; range 1–7 mm). One stem (2.4%) showed progressive subsidence (20 mm) and was considered loose. The most common cause for reoperation was dislocation (three hips, 7.3%). The 10-year survivorship with revision of the stem for any reason as the end point was 93.5% (95% CI, 84.9–100%). Conclusion: There was a significant improvement in the HHS and a low likelihood of revision at short- to mid-term follow-up, adding to the current evidence base for use of this implant in revision surgery. A longer follow-up and a larger number of cases are necessary to fully evaluate its role and performance.

Micromotion and Stress Shielding Between Taper Fluted and Cylindrical Femoral Stems for Paprosky Bone Deficiency Type IIIB

“…The 15-y survivorship with revision of the extensive porouscoated cylindrical stem was 99.3%, whereas the 10-y survivorship with revision of the taper fluted stem was 93.5% [18]. Although the component longevity between taper fluted and cylindrical femoral stem is both excellent, the taper fluted stem shows advantages not only in biomechanics study but also in the clinical outcomes.…”

Implant breakage and revision factors for modular fluted tapered stems in revision total hip arthroplasty

“…Few studies with limited samples have analysed a single type of implant in a heterogeneous patient and surgical population for MFT stems. 4,6,[19][20][21][22][23][24][25][26] Survival of different MFTs varies minimally according to the type of implant used. On the other hand, while survival is often satisfactory, implant fractures may have negatively impacted the reputation of these modular implants.…”

Revision total hip arthroplasty using a fluted, tapered, modular stem follow-up method for a mean of three years: A preliminary study

“…Typically, femoral prostheses were cemented stems, and the median age of prostheses was 8 years (0–20 years). All cases were treated using a posterior lateral approach with an average length of 14 ( Harris, 1969 ; Huskisson, 1974 ; Gruen et al, 1979 ; Sutherland et al, 1982 ; Engh and Bobyn, 1988 ; Engh et al, 1990 ; Peters et al, 1993 ; Moreland and Bernstein, 1995 ; Sivananthan et al, 2017 ; Picado et al, 2020 ) cm. The stems were fixed with a steel wire ring, except for three patients, for whom extended trochanteric osteotomy (ETO) was performed.…”