Long-term follow-up of a cemented titanium stem

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Medical device evaluation

Background:

• Cemented titanium alloy femoral stems are widely used in hip arthroplasty.
• Long-term outcomes and potential complications require thorough investigation.
• Previous studies established benchmarks for implant survival and patient function.

Purpose of the Study:

• To evaluate the 10-year clinical and radiological outcomes of the Ultima Straight Stem cemented titanium alloy femoral component.
• To assess implant survival rates, reasons for failure, and functional improvements.
• To compare outcomes against established national guidelines and contemporary implants.

Main Methods:

• Prospective follow-up of 270 patients receiving cemented titanium alloy femoral stems.
• Annual clinical and radiological assessments up to 10 years.
• Kaplan-Meier survival analysis and assessment of complications like aseptic loosening, subsidence, radiolucent lines, cement fracture, and osteolysis.

Main Results:

• 10-year survival rate was 90.1%, with aseptic loosening as the main failure mode.
• Significant improvement in Harris Hip Score from 35.3 to 79.3 at 10 years.
• Complications included stem subsidence (17 cases), radiolucent lines (11 hips), cement fracture (5 cases), and osteolysis (18 hips).

Conclusions:

• The Ultima Straight Stem's 10-year survival rate falls below current NICE recommendations.
• While functional outcomes improved, the implant's complication rates necessitate vigilant radiological monitoring.
• This implant is no longer used and has been withdrawn due to inferior performance compared to modern alternatives.