Intermediate-Term Survivorship of Total Hip Arthroplasty With a Proximally Coated Tapered-Wedge Femoral Stem: A Retrospective, Multi-Center Registry Review

Background: Short tapered-wedge stems have been used frequently over the past decade, but long-term follow-up data are not readily available in the literature. Methods: A retrospective outcomes review was conducted to assess survivorship and clinical outcomes for the TRI-LOCK® Bone Preservation Stem (TRI-LOCK BPS; DePuy Synthes, Warsaw, IN, USA), a proximally coated, tapered-wedge femoral stem. Results: In a cohort of 2,040 hips, Kaplan-Meier survivorship estimates (95% CI {confidence interval}; N with further follow-up, where N is the number of hips remaining at each post-operative interval), with survivorship defined as no revision of any component for any reason were 96.6% (92.8%,98.4%; 45) at eight years under the clinical assumption and 98.6% (97.9%,99.1%; 90) at 14 years under the registry assumption. With survivorship defined as stem revision for any reason, estimates were 97.7% (93.7%,99.2%; 45) at eight years under the clinical assumption and 99.2% (98.6%,99.5%; 90) under the registry assumption. Mean Harris Hip Scores and WOMAC scores were 90.08 and 21.98, respectively, at 10 years postoperatively. Conclusion: Our evaluation demonstrates excellent construct and stem survivorship and clinical outcomes at intermediate-term postoperative follow-up.

[1]  Zhijie Chen,et al.  Malalignment and distal contact of short tapered stems could be associated with postoperative thigh pain in primary total hip arthroplasty , 2020, Journal of Orthopaedic Surgery and Research.

[2]  G. Scott,et al.  A systematic review of short metaphyseal loading cementless stems in hip arthroplasty. , 2019, The bone & joint journal.

[3]  G. Erens,et al.  Current Trends in Clinical Practice for the Direct Anterior Approach Total Hip Arthroplasty. , 2019, The Journal of arthroplasty.

[4]  A. Leithner,et al.  Survival Rate of Short-Stem Hip Prostheses: A Comparative Analysis of Clinical Studies and National Arthroplasty Registers. , 2018, The Journal of arthroplasty.

[5]  M. Loppini,et al.  Uncemented short stems in primary total hip arthroplasty , 2018, EFORT open reviews.

[6]  T. Tamaki,et al.  Cementless Tapered-Wedge Stem Length Affects the Risk of Periprosthetic Femoral Fractures in Direct Anterior Total Hip Arthroplasty. , 2017, The Journal of arthroplasty.

[7]  C. Dora,et al.  Perioperative Fractures in Cementless Total Hip Arthroplasty Using the Direct Anterior Minimally Invasive Approach: Reduced Risk With Short Stems. , 2017, The Journal of arthroplasty.

[8]  P. Fennema,et al.  Thigh Pain Occurrence Rate in a Short, Tapered, Porous, Proximally-Coated Cementless Femoral Stem - Clinical and Radiological Results at 2-Year Follow-Up , 2017 .

[9]  J. Callaghan,et al.  Two- to 4-Year Followup of a Short Stem THA Construct: Excellent Fixation, Thigh Pain a Concern , 2017, Clinical orthopaedics and related research.

[10]  A. Lombardi,et al.  Risk of Periprosthetic Fractures With Direct Anterior Primary Total Hip Arthroplasty. , 2016, The Journal of arthroplasty.

[11]  Fan Wang,et al.  A meta-analysis of randomized controlled trials , 2016 .

[12]  D. Zukor,et al.  Favorable Results of a Short, Tapered, Highly Porous, Proximally Coated Cementless Femoral Stem at a Minimum 4-Year Follow-Up. , 2016, The Journal of arthroplasty.

[13]  Yuezheng Hu,et al.  A comparison of a short versus a conventional femoral cementless stem in total hip arthroplasty in patients 70 years and older , 2016, Journal of Orthopaedic Surgery and Research.

[14]  F. Falez,et al.  Current concepts, classification, and results in short stem hip arthroplasty. , 2015, Orthopedics.

[15]  Michael A Mont,et al.  Short bone-conserving stems in cementless hip arthroplasty. , 2014, The Journal of bone and joint surgery. American volume.

[16]  A. Shimmin,et al.  Is the length of the femoral component important in primary total hip replacement? , 2014, The bone & joint journal.

[17]  S. Stulberg,et al.  The rationale for short uncemented stems in total hip arthroplasty. , 2014, The Orthopedic clinics of North America.

[18]  S. Stulberg,et al.  The short stem: promises and pitfalls. , 2013, The bone & joint journal.

[19]  Henrik Malchau,et al.  A Review of Current Fixation Use and Registry Outcomes in Total Hip Arthroplasty: The Uncemented Paradox , 2013, Clinical orthopaedics and related research.

[20]  Joanne B. Adams,et al.  A Short Tapered Stem Reduces Intraoperative Complications in Primary Total Hip Arthroplasty , 2012, Clinical orthopaedics and related research.

[21]  A. Johnson,et al.  Short and standard stem prostheses are both viable options for minimally invasive total hip arthroplasty. , 2011, Bulletin of the NYU hospital for joint diseases.

[22]  L. Specht,et al.  Prospective, randomized comparison of cobalt-chrome and titanium trilock femoral stems. , 2009, The Journal of arthroplasty.

[23]  C. Rorabeck,et al.  The operation of the century: total hip replacement , 2007, The Lancet.

[24]  L. Dorr The appeal of the mini-incision. , 2004, Orthopedics.

[25]  T. Sculco,et al.  Minimally invasive total hip arthroplasty: the Hospital for Special Surgery experience. , 2004, The Orthopedic clinics of North America.

[26]  J. Callaghan,et al.  Results of Porous-Coated Anatomic Total Hip Arthroplasty without Cement at Fifteen Years: A Concise Follow-up of a Previous Report* , 2003, The Journal of bone and joint surgery. American volume.

[27]  W. Capello,et al.  Ten-Year Results withHydroxyapatite-Coated Total Hip Femoral Components in Patients Less Than Fifty Years Old: A Concise Follow-up of a Previous Report , 2003, The Journal of bone and joint surgery. American volume.

[28]  J. Moskal,et al.  Thigh Pain After Cementless Total Hip Arthroplasty: Evaluation and Management , 2002, The Journal of the American Academy of Orthopaedic Surgeons.

[29]  James J. Patterson,et al.  Tapered Titanium Cementless Total Hip Replacements: A 10-to 13-Year Followup Study , 2001, Clinical orthopaedics and related research.

[30]  C. Goldsmith,et al.  Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. , 1988, The Journal of rheumatology.

[31]  W. Harris,et al.  Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. , 1969, The Journal of bone and joint surgery. American volume.