Subsidence of monoblock and modular titanium fluted tapered stems in revision hip arthroplasty: A retrospective multicentre comparison study |
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| Institution: | 1. Department of Orthopaedic Surgery, University Hospital Waterford, Waterford, Ireland;2. Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 76-143 CHS, Los Angeles, CA, 90095-6902, USA;1. Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA;2. Department of Neurosurgery, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA;3. Department of Research, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA;4. Department of Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, USA;1. Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India;2. Fellow in Joint Replacement, Department of Orthopaedics, Atlas Hospitals, Tiruchirappalli, 620002, Tamil Nadu, India;3. Department of Orthopaedics, Faculty of Medicine - Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, 600095, Tamil Nadu, India;4. South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX, 78045, USA;1. Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, Harton Lane, South Shields, NE34 0PL, United Kingdom;2. Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, NE2 4HH, United Kingdom |
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| Abstract: | BackgroundTapered, fluted, titanium (TFT) stems have shown good clinical outcomes in revision total hip arthroplasty (rTHA), however concerns exist regarding early subsidence. This study compares subsidence between a modern monoblock 3-degree and a modular 2-degree TFT stem in rTHA.MethodsA retrospective, international multicentre comparative study was conducted including 64 rTHA in 63 patients. A monoblock TFT stem was used in 37 cases and a modular TFT stem was used in 27 cases. Patient demographics, Paprosky femoral bone loss classification, bicortical contact and stem subsidence were recorded at minimum four week follow up.ResultsThere was no statistically significant difference in overall subsidence (p = 0.318) or the rate of subsidence >10 mm between stems. Mean subsidence was 2.13 mm in the monoblock group and 3.15 mm in the modular group. Two stems subsided >10 mm: one in each group. There was no difference in bicortical contact between groups (p = 0.98). No re-revisions were performed.ConclusionsWe found no difference in subsidence between the two stems. Surgeons may consider the use of monoblock stems in rTHA as they have comparably low rates of subsidence and eliminate the small but potentially catastrophic risk of implant fracture at modular junctions associated with modular stems. |
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| Keywords: | Revision Hip replacement Subsidence Monoblock Modular |
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