Improved Outcome in Femoral Revision Arthroplasty with Tapered Fluted Modular Titanium Stems

Many techniques have been advanced to achieve reliable femoral stem fixation in revision total hip arthroplasty. In a cross-sectional study, we compared quality of life in 220 patients with two femoral stem designs: a modular tapered and fluted titanium stem design and a cylindrical extensively coated chrome-cobalt stem with single modularity (head size and neck length alone). We matched cohorts based on age decade and gender. The minimum followup was 1 year with a median of 2 years. Subjective outcome assessment and patient satisfaction were measured using the WOMAC Osteo-arthritis Index, the Oxford Hip Score, the SF-12, and the Arthroplasty Satisfaction Scale. At followup, all quality of life measures favored the tapered titanium stem. WOMAC pain, function, and overall scores all were higher in this group. The Oxford Hip Score and the Satisfaction score reflected a greater difference in outcome between the two stem designs. We presume reduced stiffness of the titanium stem, coupled with the intraoperative modularity, resulted in the improved patient outcomes observed in this study.

Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.