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Promising results seen with cementless stems in patients who failed intertrochanteric osteotomy

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COPENHAGEN — Cementless femoral components used in young patients who had a failed intertrochanteric osteotomy showed “encouraging” results compared with those of patients with regular femoral anatomy, according to German researchers.

Christian Merle, MD, presented his team’s findings at the 12th EFORT Congress 2011, here.

“High interoperative complication rates and poor outcomes have been reported in this subgroup of patients, and there is not much data on long-term stem performance for both cemented and uncemented femoral components,” he said.

Merle’s group performed a retrospective evaluation of results from a consecutive series of 48 total hip arthroplasties in 45 patients. Patients in the cohort underwent conversion total hip arthroplasty for a failed intertrochanteric osteotomy after a mean of 12 years. These conversions used cementless, grit-blasted, double-tapered femoral stems. The patients had an average age of 47 years.

Ten patients, who account for 11 hips, died by follow-up, and one patient was lost. Of the accounted patients, five underwent femoral revision, two underwent revision for infection and three had revisions for aseptic loosening of the stem.

Merle reported a 20-year overall stem survival rate of 91%, as well as a survival rate of 93% with femoral revision for aseptic loosening as an end point.

“Clinical and radiographic results for this type of femoral component following intertrochanteric are encouraging and even comparable to those achieved in patients with regular femoral anatomy,” Merle said. “Intertrochanteric osteotomy did not compromise the long-term stem performance. We, therefore, believe cementless femoral reconstruction provides reliable and durable long-term results.”

Reference:

• Merle C, Streit M, Inmann M, et al. Long-term survival of cementless tapered stems in THA for failed introtrochanteric osteotomy. Paper #2948. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen.

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