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Abstract
Background and purpose — Due to the relative lack of reports on the medium- to long-term clinical and radiographic results of modular femoral cementless revision, we conducted this study to evaluate the medium- to long-term results of uncemented femoral stem revisions using the modular MRP-TITAN stem with distal diaphyseal fixation in a consecutive patient series.
Patients and methods — We retrospectively analyzed 163 femoral stem revisions performed between 1993 and 2001 with a mean follow-up of 10 (5–16) years. Clinical assessment included the Harris hip score (HHS) with reference to comorbidities and femoral defect sizes classified by Charnley and Paprosky. Intraoperative and postoperative complications were analyzed and the failure rate of the MRP stem for any reason was examined.
Results — Mean HHS improved up to the last follow-up (37 (SD 24) vs. 79 (SD 19); p < 0.001). 99 cases (61%) had extensive bone defects (Paprosky IIB–III). Radiographic evaluation showed stable stem anchorage in 151 cases (93%) at the last follow-up. 10 implants (6%) failed for various reasons. Neither a breakage of a stem nor loosening of the morse taper junction was recorded. Kaplan-Meier survival analysis revealed a 10-year survival probability of 97% (95% CI: 95–100).
Interpretation — This is one of the largest medium- to long-term analyses of cementless modular revision stems with distal diaphyseal anchorage. The modular MRP-TITAN was reliable, with a Kaplan-Meier survival probability of 97% at 10 years.
MCD, MT, MDW, and SG did the retrospective and descriptive analysis, carried out the statistical analysis of the dataset and drafted the manuscript. MCD, MT, RA, UN, UM, and RF contributed by performing patient follow-up visits, radiographic analysis, gathering of data, and translation or revision of the manuscript. DCW conceived the study and its design, was one of the main surgeons besides GZ, conducted the realization of the study and edited the manuscript. All the authors read and approved the final manuscript.
The study was funded by Peter Brehm GmbH, Weisendorf, Germany. The authors are grateful for the data supplied by the Wichernhaus Orthopaedic Clinic at Rummelsberg Hospital, Schwarzenbruck; the Orthopaedic University Medical Center, Würzburg; the Orthopaedic University Medical Center, Erlangen; and the University Medical Center, RWTH Aachen, Aachen.
Peter Brehm GmbH, Weisendorf, Germany, acted as sponsor of the study. SG has received research grants from the same institution. The authors declare that they have no other competing interests.