Abstract
Introduction
Primary hip replacement in young active patients is on the increase. Due to the demands set by the patient, implants used in this patient group should have a proven long-term clinical and radiological outcome. We report our results in patients under the age of 50 using the C-Stem femoral component – a cemented triple tapered polished stem.
Methods
Since the C-stem femoral component was introduced into clinical practice in 1993, 6906 C-stems have been used in primary hip replacements at our hospital. In this group, 896 patients were under the age of 50 at the time of surgery. We report the first 300 consecutive C-stems from this group. The surgical technique of using a bone block to allow subsidence and clearing of the calcar to increase loading of the proximal femur medially was routinely used together with a femoral cement gun and pressurizer.
Results
130 males and 170 females with a mean age at surgery of 38.6 years (range 15–50) and a mean follow-up of 12 years (1 – 20) were reviewed. 207 hips had a follow-up of more than 10 years and 106 hips with follow-up more than 15 years. The main diagnosis groups were Osteoarthritis in 20.3%, Congenital dysplasia, subluxation or dislocation in 34%, Avascular Necrosis in 20% and Rheumatoid Arthritis in 8%. In the follow-up period 3 stems (1%) were recorded as radiologically loose of which 2 have been revised, one stem (0.3%) had fractured, and has subsequently been revised. The survivorship with endpoint as revision of the stem was 96.44% at 17 years.
Conclusion
In this demanding and diverse group of patients our clinical and radiological results of the C-stem and the surgical technique used are encouraging and support the concept of loading the proximal femur. Follow-up in this patient group is essential.
