Mid-Term Behaviour of Cemented Titanium Stems: A Seven to Eleven Year Clinical Radiographic and Retrieval Study

A controversy exists regarding the results of cemented Ti-alloy femoral stems. Although most authors reported unfavourable results, there is no clear evidence of the exact reason for the increased failure rate. We studied 35 arthroplasties in 30 patients with a mean age at the time of surgery of 49.7 years (range 27 to 67 years). In most of them (23 hips) the pre-operative diagnosis was hip dysplasia or dislocation. The femoral component used in this study was the Optifix stem. Survival analysis showed a cumulative rate of success at nine years of 90.4% (±15.3) with 25.5 femoral components remaining at risk. Three femoral components were retrieved during revision surgery: due to fatigue fracture, fracture of the femur and aseptic loosening respectively. Given that most publications refer to different designs of stems we presume that the problem could be focused on the design rather than the material or the method of fixation. Further information is necessary before Ti-alloy stems fixed with cement are withdrawn from use.