Long-term (20- to 25-year) results of an uncemented tapered titanium femoral component and factors affecting survivorship
Background - Uncemented femoral components in primary total hip arthroplasty (THA) are commonly used today, but few studies have evaluated their survival into the third decade. - Questions/purposes - We evaluated (1) survivorship using femoral revision for any reason as the...
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| Hauptverfasser: | , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2013
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| In: |
Clinical orthopaedics and related research
Year: 2013, Jahrgang: 471, Heft: 10, Pages: 3262-3269 |
| ISSN: | 1528-1132 |
| DOI: | 10.1007/s11999-013-3033-4 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s11999-013-3033-4 Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/clinorthop/Fulltext/2013/10000/Long_term__20__to_25_year__Results_of_an.35.aspx 
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| Verfasserangaben: | Marcus R. Streit, Moritz M. Innmann, Christian Merle, Thomas Bruckner, Peter R. Aldinger, Tobias Gotterbarm |
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| 245 | 1 | 0 | |a Long-term (20- to 25-year) results of an uncemented tapered titanium femoral component and factors affecting survivorship |c Marcus R. Streit, Moritz M. Innmann, Christian Merle, Thomas Bruckner, Peter R. Aldinger, Tobias Gotterbarm |
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| 520 | |a Background - Uncemented femoral components in primary total hip arthroplasty (THA) are commonly used today, but few studies have evaluated their survival into the third decade. - Questions/purposes - We evaluated (1) survivorship using femoral revision for any reason as the end point; (2) survivorship using femoral revision for aseptic loosening as the end point; and (3) patient-related and surgical risk factors for aseptic stem loosening at a minimum 20-year followup with an uncemented tapered titanium stem. - Methods - We reviewed the clinical and radiographic results of 354 THAs in 326 patients performed between January 1985 and December 1989 using an uncemented grit-blasted, tapered titanium femoral stem. Mean age at surgery was 57 years (range, 13-81 years). Kaplan-Meier survivorship analysis was used to estimate long-term survival. Minimum followup evaluation was 20 years (mean, 22 years; range, 20-25 years); at that time, 120 patients (127 hips) had died, and four patients (five hips) were lost to followup. Multivariate survival analysis using a Cox regression model was performed. - Results - Survivorship at 22 years with revision of the femoral component for any reason as the end point was 86% (95% confidence interval [CI], 81%-90%). Survivorship for femoral revision for aseptic loosening as the end point was 93% at 22 years (95% CI, 90%-96%). Undersized stems (canal fill index ≤ 80%) and stems in hips with cup revision were at higher risk for aseptic loosening (hazard ratio, 4.2 and 4.3, respectively). There was a high rate of acetabular revision in this series (38%), mostly related to smooth-threaded, cementless sockets. - Conclusions - Uncemented femoral fixation was reliable into the third decade. Age, male sex, and diagnosis were not associated with a higher risk of aseptic loosening. - Level of Evidence - Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. | ||
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