Elsevier

The Journal of Arthroplasty

Volume 30, Issue 10, October 2015, Pages 1772-1776
The Journal of Arthroplasty

A Cannulated Tri-Tapered Femoral Stem for Total Hip Arthroplasty: Clinical and Radiological Results at Ten Years

https://doi.org/10.1016/j.arth.2015.04.023Get rights and content

Abstract

We report the ten-year clinical and radiological outcomes of a novel cannulated, tri-tapered femoral stem, used in primary total hip arthroplasty (110 stems in 98 patients). At ten years, two Tri-taper stems had been revised for infection and dislocation. The mean Oxford Hip Score improved from 13.46 pre-operatively, to 37.04. Radiological analysis revealed radiolucent lines in 57 cases, but none exceeded 2 mm thickness. Stem subsidence was identified in 63 cases, with mean distal tip migration of 3.8 mm. Survivorship with revision for aseptic loosening as the end point was 100% at 10 years. Stem survival with revision for any cause was 98.2% (95% CI, 92.9% to 99.5%). The ten-year results of the Tri-taper stem are comparable to other polished, tapered femoral stems.

Section snippets

Patients and Methods

A prospective clinical study of the Tri-taper femoral stem was commenced in 1997. Ethical committee and Medical Devices Agency approval was granted for the study. Patients with osteoarthritis of the hip, aged between 65 and 85 years and suitable for primary THA were eligible for participation. Patients with significant co-morbidities that could affect their recovery to independent mobility, or had a life expectancy of less than five years were excluded from the study. All patients provided

Results

At the ten-year time point, 22 patients (23 hips) had died, five patients (5 hips) had withdrawn from the study and two patients (2 hips) were lost to follow-up (at 5 and 9 years respectively). The average follow-up time was 8.9 years ± 2.2. All results from these patients, up to the point of loss from the study, were included in the final analysis. The reasons for patient withdrawal include: cancer (2 patients at 5.5 years and 9 years); psychiatric illness (2 patients at 1 year and 6 years) and after

Discussion

The design specification for the Tri-taper femoral stem sought to utilise a combination of design features that had been reported as beneficial. The long-term performance of the polished Roundback Charnley low-friction torque arthroplasty (Thackray, Leeds UK), and the Exeter Universal femoral component (Stryker, Mahwah, New Jersey) has supported the use of polished tapered cemented stems, fabricated from stainless steel 8., 9., 10..

The pilot study of the Tri-taper stem investigated the clinical

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  • Cited by (1)

    • Minimum 10-Year Follow-Up of Total Hip Arthroplasty With a Collarless Triple-Tapered Polished Cemented Stem With Line-to-Line Implantation Using a Direct Anterior Approach

      2022, Journal of Arthroplasty
      Citation Excerpt :

      However, the radiological evidence without aseptic loosening over a long follow-up period reinforced the advantage of creating an optimal compressive force by transfer of loading at the cement-bone interface according to the taper-slip principle. Among the available different designs of femoral component, the polished, tapered, and collarless stem, in which the design converts shear forces to radial compressive forces by allowing stem subsidence within the cement mantle, have excellent middle-term to long-term survivorship [4,22,24,25,62,65,66]. The ideal cement mantle thickness surrounding the femoral component also has remained a matter for debate.

    One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2015.04.023.

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