JBJS, November 1, 2002, Volume 84, Issue 11

Why a Taper?

Thomas H. Mallory, MD, FACS Adolph V. Lombardi, Jr., MD, FACS Joseph R. Leith, MD Hiroshi Fujita, MD Jodi F. Hartman, MS Susan G. Capps, PhD Cheryl A. Kefauver, RN Joanne B. Adams, BFA G. Christian Vorys
Hip

The purpose of this study was to substantiate the continued use of a cementless plasma-sprayed, proximal-to-distal dual-tapered-geometry femoral-component design on the basis of long-term clinical and radiographic evidence. This justification is particularly pertinent in cementless total hip arthroplasty, in which bone-stock preservation and prosthetic-host compatibility are essential. A series of 101 patients managed with 120 primary arthroplasties who had a minimum follow-up of ten years was retrospectively reviewed. A meta-analysis of published reports of cementless tapered femoral components with a minimum follow-up of five years then was performed to validate the results of this review. At a mean follow-up of 12.2 years, a mean 38-point improvement in the Harris hip score was observed. Thigh pain was mild or absent after 97.5% (117) of the 120 arthroplasties. Distal femoral osteolysis was observed after 1.7% (two). Three femoral components had been revised secondary to aseptic loosening, yielding a 97.5% survivorship.


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