Abstract
Introduction and Aims: Successful cementless total hip arthroplasty (THA) is well documented, with increasing reports in elderly patients. Concerns exist with respect to the ability to achieve and maintain long-term cementless femoral fixation in this patient population. This study reviews the clinical and radiographic outcomes of a tapered porous femoral component in cementless THA in elderly patients.
Method: Forty-nine hips in 47 patients over 74 years of age underwent primary cementless THA with a tapered stem between April 1996 and April 2000. All femoral heads were sent to pathology. Radiographs, Harris hip scores and clinical data were evaluated. Revision status was known for all hips.
Results: Average age: 79 years, mean follow-up was 46 months. Six patients died during the study (mean 40 months) all THA unrelated. Twenty-two peri-operative variances occurred. There were no dislocations. Three irrigation and drainage procedures were performed, and no revisions. Mean post-operative HHS improved by 33, with 87 percent of patients having no or minimal pain. We identified two cases of stem subsidence to a stable position with no progressive radiolucencies. Mean length of stay was 4.5 days. One patient required intensive care, 52 percent were discharged to home. Metastatic cancer was identified in one femoral head.
Conclusion: Using revision status as an end-point, the success rate was 100 percent. No peri-operative deaths or significant orthopaedic complications were identified. Advanced age and Dorr C anatomy is not a contraindication for tapered cementless THA. The femoral head should routinely be sent to pathology.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
