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10 years results of an uncemented metaphyseal fit modular stem in elderly patients

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Abstract

Background: There are concerns with regard to the femoral fixation in cementless total hip arthroplasty in elderly patients. We report a retrospective analysis of clinical and radiological results of uncemented metaphyseal fit modular stem in elderly patients irrespective of anatomic characterstics of proximal femur.

Materials and Methods: This study reviews the outcomes of 60 primary hip replacements using a metaphyseal fit modular stem (third-generation Omniflex stem) conducted in 54 patients, of age 75 years or older. After a mean follow-up of 10,4 years, complete clinical and radiographic records were available for 52 hips of 48 patients. The patients were evaluated by Harris Hip Score (HHS).

Results: There was a significantly improved pain score and Harris Hip Score (41,6 to 83,2). Six stems (11.53%) were revised: four because of periprosthetic fracture; one stem was well fixed, but presented a large osteolytic lesion in the metaphyseal area and the last stem was revised because of aseptic loosening. Stem survival taking aseptic loosening as the end-point was 98%. Bone atrophy in the proximal femur caused by stress shielding was observed in 39 stems (75%), but there was no case of subtrochanteric stress shielding. Moreover, atrophy appeared within two years postoperatively, with no extension thereafter.

Conclusions: We achieved good clinical and radiographic results by uncemented metaphyseal fit femoral stem regardless of patient’s age and femoral canal type.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, University Hospital of Guadalajara, Alcala University, Guadalajara, Spain

    Basilio J. De la Torre (Professor of Orthopedic Surgery), Manuel Chaparro & Juan O. Romanillos

  2. Department of Orthopedics, Faculty of Medicine, Alcala University, Alcala de Henares, Madrid, Spain

    Basilio J. De la Torre (Professor of Orthopedic Surgery) & Sara Zarzoso

  3. Department of Preventive Medicine and Public Health, Alcorcón University Hospital, Alcorcón, Madrid, Spain

    Margarita Mosquera & Gil Rodriguez

Authors
  1. Basilio J. De la Torre
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  2. Manuel Chaparro
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  3. Juan O. Romanillos
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  4. Sara Zarzoso
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  6. Gil Rodriguez
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Correspondence to Basilio J. De la Torre.

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De la Torre, B.J., Chaparro, M., Romanillos, J.O. et al. 10 years results of an uncemented metaphyseal fit modular stem in elderly patients. IJOO 45, 351–358 (2011). https://doi.org/10.4103/0019-5413.80328

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