Abstract
The use of tapered, fluted, modular, distally fixing stems has increased in femoral revision surgery. The goal of this retrospective study was to assess mid- to long-term outcomes of this implant in femoral revision with bone loss. Seventy-one hips in 70 patients with a mean age of 68.5 years were followed for an average of 10 years. Pre-operative HHS averaged 50 and improved to an average of 87 post-operatively. Seventy-nine percent hips had Paprosky type 3A, 3B or 4 bone-loss and 44% had an associated proximal femoral osteotomy. All stems osseointegrated distally (100%). Two hips subsided >5mm (mean 8mm) but achieved secondary stability. Sixty-eight percent hips had evidence of bony reconstitution and 21% demonstrated diaphyseal stress-shielding. One stem fractured at its modular junction and was revised with a mechanical failure rate of 1.4%. Distal fixation and clinical improvement were reproducibly achieved with this stem design.
