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Indian J Orthop. 2011 Jul;45(4):351-8. doi: 10.4103/0019-5413.80328.

10 years results of an uncemented metaphyseal fit modular stem in elderly patients.

Author information

  • 1Department of Orthopedic Surgery, University Hospital of Guadalajara, Alcala University, Guadalajara.

Abstract

BACKGROUND:

There are concerns with regard to the femoral fixation in cementless total hip arthroplasty in elderly patients. We report a retrospective analysis of clinical and radiological results of uncemented metaphyseal fit modular stem in elderly patients irrespective of anatomic characterstics of proximal femur.

MATERIALS AND METHODS:

This study reviews the outcomes of 60 primary hip replacements using a metaphyseal fit modular stem (third-generation Omniflex stem) conducted in 54 patients, of age 75 years or older. After a mean follow-up of 10,4 years, complete clinical and radiographic records were available for 52 hips of 48 patients. The patients were evaluated by Harris Hip Score (HHS).

RESULTS:

There was a significantly improved pain score and Harris Hip Score (41,6 to 83,2). Six stems (11.53%) were revised: four because of periprosthetic fracture; one stem was well fixed, but presented a large osteolytic lesion in the metaphyseal area and the last stem was revised because of aseptic loosening. Stem survival taking aseptic loosening as the end-point was 98%. Bone atrophy in the proximal femur caused by stress shielding was observed in 39 stems (75%), but there was no case of subtrochanteric stress shielding. Moreover, atrophy appeared within two years postoperatively, with no extension thereafter.

CONCLUSIONS:

We achieved good clinical and radiographic results by uncemented metaphyseal fit femoral stem regardless of patient's age and femoral canal type.

KEYWORDS:

Cementless femoral stem fixation; elderly; hydroxyapatite-coated stem; modular omniflex stem; stress shielding

PMID:
21772630
[PubMed]
PMCID:
PMC3134022
Free PMC Article

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