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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 2/2011

01-02-2011 | Symposium: Papers Presented at the Hip Society Meetings 2010

Modular Femoral Sleeve and Stem Implant Provides Long-term Total Hip Survivorship

Authors: David Le, MD, Karen Smith, CRA, Dylan Tanzer, Michael Tanzer, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2011

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Abstract

Background

A femoral implant with a modular sleeve and stem has been designed to allow independent and complete metaphyseal-diaphyseal fit and fill as well as independent rotation to accommodate anteversion at the time of THA.

Questions/purposes

In a prospective study we asked whether such a modular femoral sleeve and stem implant used during THA could provide (1) high long-term survivorship; (2) radiographically stable implants without radiolucencies, stress shielding, or osteolysis; and (3) high clinical scores in patients 15 to 20 years after a primary THA.

Patients and Methods

We prospectively evaluated 31 hips that underwent a primary THA using a modular femoral component for clinical outcome (Harris hip score) and radiographic outcome (implant stability, femoral loosening, osteolysis and stress shielding) at a minimum followup of 15 years (mean, 17 years; range, 15–20.2 years).

Results

There were no femoral revisions for aseptic loosening; all hips had radiographic evidence of bone ingrowth. Two well-ingrown components were revised for late hematogenous infection. Some degree of proximal femoral disuse atrophy from stress shielding occurred in 23 hips (74%) but was nonprogressive and did not result in any failures or complications. Femoral osteolysis occurred in 18 hips (58%), but we cannot definitively determine whether or not the modular junction contributed to this.

Conclusions

These data suggest this modular femoral stem can provide long-term survivorship with no cases of aseptic loosening at 15 to 20 years after primary THA. However, it may be prudent when using this femoral stem to consider an articulation with an alternative bearing or, if the modularity is not needed to address femoral anteversion and metaphyseal-diaphyseal mismatch, to consider a nonmodular femoral stem.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Modular Femoral Sleeve and Stem Implant Provides Long-term Total Hip Survivorship
Authors
David Le, MD
Karen Smith, CRA
Dylan Tanzer
Michael Tanzer, MD
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1524-0

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