The short and "shorter" of it: >1750 tapered titanium stems at 6- to 88-month follow-up.

Abstract

Femoral fixation in THA can be achieved with different design rationales. Our hypothesis was that two short titanium flat-tapered stems would demonstrate similar stability. Between May 2005 and May 2012, 849 short (135-170mm), titanium flat stems ("Short") were used in THA. Between July 2005 and May 2012, 902 similar, but 35-mm shorter, stems ("Shorter") were utilized. Harris Hip Score, radiographic, and survivorship data were analyzed. Survivorship of the "Short" stems was 99.1% at 7years. Eight of 849 stems have been revised: 4 for loosening, 3 for fracture, and 1 for infection. Harris Hip Score improved from 41.6 to 88.9. In the "Shorter" group, 9 of 902 have been revised: 6 for fracture/loosening, 2 for infection, and 1 for instability. HHs improved from 43.7 to 92.0. No statistically significant differences were noted in revision rate. This comparison study of short titanium tapered stems has confirmed similar >99% survivorship in >1750 THA stems at 6- to 88 (mean 36)-month follow-up. Early periprosthetic fracture, although rare (0.5%), was more likely to occur in older patients.