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Stable Fixation of a Cementless, Proximally Coated, Double Wedged, Double Tapered Femoral Stem in Total Hip Arthroplasty: A 5-Year Radiostereometric Analysis

Journal article
Authors A. K. Nebergall
Ola Rolfson
H. E. Rubash
Henrik Malchau
A. Troelsen
Meridith E Greene
Published in Journal of Arthroplasty
Volume 31
Issue 6
Pages 1267-1274
ISSN 0883-5403
Publication year 2016
Published at Institute of Clinical Sciences, Department of Orthopaedics
Pages 1267-1274
Language en
Keywords total hip arthroplasty, radiostereometric analysis, patient-reported outcome measures, 10-YEAR FOLLOW-UP, LONG-TERM, PROSTHESES, COMPONENT, FAILURE, SURVIVORSHIP, REPLACEMENTS, REGISTER, MINIMUM, DESIGN
Subject categories Orthopedics


Background: The objective of this 5-year prospective study of 51 hips was to assess migration of a cementless tapered femoral stem using radiostereometric analysis (RSA), plain radiographs (radiolucencies), and patient-reported outcome measures (PROMs). Methods: Forty-seven patients (51 hips) agreed to participate in this prospective RSA study. All patients received a Taperloc stem. Tantalum beads were inserted into the femoral bone surrounding the stem to measure migration using RSA. RSA films, plain radiograph, and PROM follow-up were obtained immediately after surgery, 6 months, 1, 2, 3, and 5 years after surgery. Results: The median (interquartile range) subsidence was 0.03 mm (-0.23 to 0.06) at 5 years, with no significant differences over time. Four outlier stems had >1.5 mm of subsidence by 1 year. No stem showed radiolucencies in more than 3 zones during the 5 years. All PROMs remained favorable at 5 years, suggesting an excellent outcome. There were no stems revised for mechanical loosening; 1 stem was revised for an infection. Conclusion: After initial settling, the cementless tapered femoral stems in our series were stable. The 4 outlier stems with >1.5 mm of subsidence by 1 year remain stable at 5 years. RSA was the most sensitive method of detection for stems at greater risk for potential future failure. This report adds contributions to the positive results associated with this type of fixation. The results at 5 years showed excellent midterm survivorship in this cohort with a cementless tapered femoral component. (C) 2015 Elsevier Inc. All rights reserved.

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