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Updated: Jun 12, 2026
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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Revision total hip arthroplasty with a modular tapered stem
Dror Lakstein1, Yona Kosashvili, David Backstein
1Orthopaedic Department, Mount Sinai Hospital, Toronto, Ontario, Canada. drorale@gmail.com
Summary
The ZMR tapered stem shows good survivorship and functional improvement for femoral revision surgery with bone loss. This study confirms its satisfactory results over 2 to 10 years in various revision scenarios.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Reconstructive Surgery
Background:
- Femoral stem revision with proximal bone loss presents challenges.
- Modular uncemented distal fixation stems offer a potential solution.
- Early ZMR tapered stem results were promising.
Purpose of the Study:
- To evaluate the 2-to-10-year survivorship of the ZMR tapered stem in femoral revision.
- To assess associated complications and functional outcomes.
- To determine the efficacy of ZMR tapered stems in diverse revision conditions.
Main Methods:
- Prospective study of 84 femoral revision cases using ZMR tapered stems.
- Indications included aseptic loosening, periprosthetic fracture, infection, stem fracture, and instability.
- Kaplan-Meier survival analysis and Harris hip score assessment were performed.
Main Results:
- The Kaplan-Meier survival rate was 92.7% (95% CI: 87.7%-97.7%) at a mean follow-up of 46 months.
- The mean Harris hip score improved significantly from 37 to 72 points.
- Satisfactory outcomes were observed across various revision indications.
Conclusions:
- The ZMR tapered stem demonstrates favorable survivorship and functional outcomes in femoral revision surgery.
- It is a viable option for addressing proximal bone loss and other revision complexities.
- The stem provides reliable results over a 2-to-10-year follow-up period.
