Clinical and functional outcomes of a modular fluted titanium stem in complex hip surgery with femoral bone loss

Abstract

Background

The tapered fluted titanium stem is a viable option for complex hip reconstruction. We therefore, evaluate the results of complex hip arthroplasty for femoral bone loss (Paprosky type IIIA to type IV femoral defect), using a modular fluted titanium stem.

Methods

Data for this retrospective study was collected from the medical records of the 2 participating orthopaedic units from December 2018 to December 2021. Twenty-seven patients who underwent reconstruction of femoral bone loss with a modular fluted titanium stem were included in this study. General, demographic and clinical data including patient's age, comorbidities, ambulatory status before and after surgery, blood transfusion, surgical complications, rehabilitation after surgery, length of stay in hospital (in days), readmission after surgery, implant details and mortality rate were recorded. Clinical evaluation was performed using the oxford hip score and 12-item short-form health survey (SF-12). Complications and survivorship were evaluated using Kaplan–Meier survival rate with 95 % confidence interval.

Results

The mean age for the cohort was 60.14 ± 11.58 years, with mean follow-up of 3.2 years for the study. The median pre-operative OHS was 10 (8), which improved to 39 (12) and 41 (4) at 1 and 2-year postoperative follow-up, respectively (P < 0. 001). The quality of life measures (SF-12 scores) in both mental and physical components showed progressive improvement at 2 years follow-up with P- value < 0.001. A total of five patients (18.5 %) had postoperative complications, including deep venous thrombosis in one patient, dislocations in two patients and one patient each with superficial and deep infection. The implant survival rate was 100 % at mean follow-up of 3.2 years.

Conclusions

Proximal femur reconstruction with a modular fluted titanium stem restores mobility, improves the quality of life and reduces pain significantly. It can be considered as a good option as a salvage procedure.