Second-generation proximally coated titanium femoral component: minimum 7-year results

Paul F Lachiewicz, Elizabeth S Soileau, Paul Bryant
Clinical Orthopaedics and related Research 2007, 465: 117-21
It is unclear whether resurfacing or fully porous-coated or proximally coated stems are the best femoral components for young patients. First-generation proximally coated titanium fiber-metal femoral components had a high rate of failure. We prospectively followed 56 patients (70 hips) whom we believed were at high risk for loosening of a cemented femoral component; all patients were implanted with one second-generation proximally coated titanium femoral component. Ten patients (11 hips) died and three patients (four hips) were lost to minimum followup. Three models of titanium fiber-metal acetabular component were implanted with screws. Patients were clinically evaluated using the Harris hip score. We used standardized radiographs to assess fixation status and osteolysis. Forty-four patients (55 hips) with a mean age of 45 years were followed for a minimum of 7 years (mean, 10.5 years; range, 7-15 years). No femoral component had been revised for any reason. Bone ingrowth (spot welding) was seen in 41 hips (75%) and proximal femoral osteolysis in only four hips. Reoperations for polyethylene wear were performed in seven patients (12.7%) and two patients had liner exchange for recurrent dislocation. Even with an articulating surface with considerable polyethylene wear debris, these second-generation proximally coated titanium fiber-metal femoral components had a survival rate of 100% at a mean 10.5-year followup.

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