Long-Term Survival (up to 34 Years) of Retained Cementless Anatomic Femoral Stem in Patients <50 Years Old

There is a paucity of studies longer than 30 years to determine clinical and radiographic results of retained cementless anatomic stem. The purpose of this study is to determine the long-term (up to 34 years) survival rate of the retained cementless anatomic femoral stem in patients <50 years of age.

Isolated cup revision was performed with retaining primary cementless anatomic femoral stem in 206 patients (149 men and 57 women). Clinical and radiographic results were monitored at each follow-up. At the latest follow-up, computed tomography scans were carried out in all hips to determine the prevalence of osteolysis. The mean follow-up of the retained femoral stem was 30.3 years (range 27-34). The mean follow-up of the revised cup was 25.5 years (range 22-29).

The mean Harris Hip Score was 91 ± 7.8 points (range 71-100) and the mean Western Ontario and McMaster Universities Osteoarthritis score was 16 ± 7 points (range 7-34) at the final follow-up. The mean University of California, Los Angeles activity score was 7 ± 4 points (range 5-10) at the final follow-up. The overall survival rate of retained cementless femoral stems was 98.9% (95% confidence interval 91-100) at 30.3 years. The survival rate of the revised cup was 93% (95% confidence interval 89-98) at 25.5 years.

The rate of aseptic loosening of already osseointegrated femoral stem remains low with ceramic-on-ceramic bearing in young active patients.