Clinical Performance of an Ultrashort, Proximally Porous-Coated and Tapered Metaphyseal-Fitting Cementless Femoral Stem Among Octogenarians

Abstract

Total hip arthroplasty (THA) among octogenarians presents greater challenges than among the younger patient population because of the high risk of perioperative morbidity and mortality and poor bone quality. We determined the clinical performance and radiographic results of an ultrashort, proximally porous-coated and tapered metaphyseal-fitting cementless femoral stem for octogenarians. A total of 100 unselected octogenarians (112 hips) were included in this retrospective study. All patients received the ultrashort, proximally porous-coated and tapered cementless stem during the study period, but patients who could not walk preoperatively were excluded from the analysis. Their mean age was 82.3±12.1 years (range, 80–92 years). Assessment was performed with the Harris Hip Score; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score; thigh pain; University of California, Los Angeles (UCLA) activity score; and radiographic results. The mean duration of follow-up was 7.6 years (range, 6–9 years). At the final follow-up, the mean Harris Hip Score was 87±13 points, the mean WOMAC score was 26±8 points, and the mean UCLA activity score was 4.5 points. Osseointegration was obtained for 105 (94%) acetabular components and 110 (98%) femoral components. Kaplan-Meier survivorship analysis at 9 years showed that the survival rate for the acetabular component was 94% (95% CI, 91–98) and that of the femoral component was 98% (95% CI, 91–100), with aseptic loosening or revision as the end point. The ultrashort cementless femoral component provides stable fixation without the need for diaphyseal fixation among octogenarians. [ Orthopedics . 2022;45(3):181–186.]