Abstract
Introduction The importance of soft tissue and bone preservation at total hip replacement is well recognised. This paper reviews the results of a stem designed not to contact the femoral cortex, thus ensuring exclusive metaphyseal loading.
Methodology Eighty-one consecutive metaphyseal bearing cementless stems were followed up for 2 – 6 years (mean 3 years 9 months).
There were 27 male and 46 female patients (8 bilateral). The mean age was 42 (range 18 to 57). Secondary osteoarthritis was the most common presenting pathology. There were no exclusion criteria beyond those applicable to any replacement arthroplasty.
Results One hip was revised for deep infection. Five hips required cerclage wiring of an intra-operative calcar fracture and there was one post-operative dislocation. One patient, who was being treated for an acute psychotic condition, complained of severe pain. Three patients complained of mild to moderate discomfort in the region of the greater trochanter. The remaining patients were asymptomatic and there was no thigh pain.
There was no evidence of stem subsidence. A sclerotic line was frequently observed around the non-coated distal stem. Buttressing of the coated area was almost universally seen in the metaphyseal region. There were no radiolucent lines in any of the zones around the textured area in the metaphyseal region.
Conclusion These findings persuaded the authors that the stem of the femoral component was superfluous. This paper includes a preliminary report of the initial experience with a conservative, bone and soft tissue sparing metaphyseal femoral implant. Early results are encouraging.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
