Results of Revision Total Hip Arthroplasty with Modular, Titanium-Tapered Femoral Stems in Severe Proximal Metaphyseal and Diaphyseal Bone Loss

Evidence supporting modular, tapered stems for severe proximal metaphyseal and diaphyseal bone loss is limited. We report our clinical experience with its use for severely deficient femurs. Of 211 revision total hip arthroplasties (THAs), 18 tapered, modular titanium stems were implanted in Paprosky type III and IV femurs. Clinical data were reviewed for function, stability, structural failure and revision surgery at a mean follow-up of 4.5 years. The overall survival rate was 94%. One required revision due to infection and subsidence. The mean subsidence was 3.5 mm and the mean pre- and post-operative Harris Hip score was 56 and 79, respectively. In surviving cases, patients achieved satisfactory function and there were no mechanical failures. Modular, tapered stems demonstrated acceptable outcomes for management of severe proximal metaphyseal and diaphyseal defects. (C) 2013 Elsevier Inc. All rights reserved.