Cementless titanium tapered-wedge femoral stem: 10- to 15-year follow-up

This investigation is an ongoing clinical and radiographic analysis of a titanium tapered-wedge femoral component with a proximal plasma-spray porous coating. Integral femoral stems (Biomet, Warsaw, IN) were implanted in 200 hips in 186 patients. Nineteen patients died before 10-year follow-up, and 50 patients were lost to follow-up. The mean follow-up of the remaining 129 hips was 11.6 years. Harris Hip Scores improved from 58 to 93. Thigh pain was 2.3%. Radiographic analysis revealed adaptive distal remodeling in zones 2, 3, 5, 6, and 13, with no evidence of osteolysis below the level of the calcar and the greater trochanteric region. Only 2 femoral stems were revised: 1 with suspected fibrous fixation at 7 years postoperatively and another with a broken trunion at 10 years postoperatively. A tapered titanium femoral stem with circumferential plasma-spray porous coating provides excellent long-term fixation, durable clinical outcome, and protects against osteolysis below the level of the calcar and greater trochanter.