Clin Orthop Surg.  2023 Apr;15(2):211-218. 10.4055/cios22197.

The Early- to Mid-term Outcome of Novel Cementless Modular Femoral Stem in East Asian Patients

• Kim HS
• Park JW
• Lee YK
• Yoo JJ

• KMID: 2540439
• DOI: http://doi.org/10.4055/cios22197

Abstract

Background
Early firm fixation of the femoral implant is crucial in total hip arthroplasty (THA) with unstable metaphysis or a large degree of femoral bone loss. This study aimed to evaluate the outcomes of THA using a novel cementless modular, fluted, tapered stem in such cases.
Methods
From 2015 to 2020, 105 hips (101 patients) had surgery performed by two surgeons at two tertiary hospitals using a cementless modular, fluted, tapered stem for periprosthetic fractures, massive bone loss, prosthetic joint infection sequelae, or tumorous condition. Clinical outcomes, radiographic results, and survivorship of the implant were evaluated.
Results
The average follow-up period was 2.8 years (range, 1–6.2 years). The Koval grade was 2.7 ± 1.7 preoperatively and maintained at 1.2 ± 0.8 at the latest follow-up. The plain radiograph showed bone ingrowth fixation in 89 hips (84.8%). The average stem subsidence at postoperative 1 year was 1.6 ± 3.2 mm (range, 0–11.0 mm). Five reoperations (4.8%) were needed, including 1 for acute periprosthetic fracture, 1 for recurrent dislocation, and 3 for chronic periprosthetic joint infection. Kaplan-Meier survivorship with reoperation for any reason as the endpoint was 94.1%.
Conclusions
The early- to mid-term results of THA with the novel cementless modular, fluted, tapered THA stem system were satisfactory clinically and radiologically. The shortcomings inherent to its modularity were not identified. This modular femoral system may provide adequate fixation and be a practical option in the setting of complicated THA.

Keyword

Revision total hip arthroplasty; Femoral revisions; Tapered modular stem