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Updated: Jul 27, 2025
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Revision total hip arthroplasty using a fluted, tapered, modular stem follow-up method for a mean of three years: A
Shu-Xing Xing1, Qiang Huang1, Zheng-Jiang Li1
1Department of Orthopedic Surgery, Chengdu Fifth People's Hospital, Chengdu, China.
Insights
Revision total hip arthroplasty using a modular tapered stem showed excellent survival and functional improvement. This versatile implant facilitated rapid bone reconstruction with manageable complications in the short-to-medium term.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
Background:
- Revision total hip arthroplasty (rTHA) addresses complications from primary hip replacements.
- Short-to-medium term outcomes of specific implant designs require evaluation.
Purpose of the Study:
- To assess the efficacy and complications of a fluted, tapered modular stem in rTHA.
- To evaluate functional outcomes and bone regeneration following revision surgery.
Main Methods:
- Retrospective review of 31 rTHA cases using a specific modular tapered stem (Jan 2016-Jan 2020).
- Analysis of implant survival, functional scores (Harris hip score), and complications.
- Radiographic assessment of bone regeneration and implant fixation.
Main Results:
- 100% implant survival rate with no re-revisions at a median follow-up of 36 months.
- Significant improvement in Harris hip score (36.5 to 81.8).
- Complications included intraoperative fractures (12.9%) and dislocations (25.8%); no infections or stem breakages.
Conclusions:
- The modular tapered stem is versatile for femoral revisions, enabling rapid bone reconstruction.
- Positive short-to-medium term results suggest potential for improved patient function.
- Long-term follow-up is necessary to validate sustained outcomes and implant durability.
Abstract:
Objective: This study aimed to evaluate the results and complications related to revision total hip arthroplasty within a short-to-medium follow up period. Methods: From January 2016 to January 2020, we reviewed 31 prosthetic hip arthroplasty stem revisions using a fluted, tapered modular stem with distal fixation. The median age of the patients was 74.55-79 years. The survival rate was 100%, and there were no re-revisions. The Harris hip score improved from an average of 36.5 ± 7.8 before surgery to 81.8 ± 6.2 at the final follow-up. Results: The average final follow-up was 36 (24-60) months. During this time, there was no periprosthetic infection, no prosthesis loosening or breakage, and no sciatic nerve injury. Complications included four (12.9%) intraoperative fractures and eight (25.8%) dislocations that had no stem fractures. The postoperative limb was lengthened by 17.8 ± 9.8 mm. In most cases, bone regeneration was an early and important finding. Three cases underwent extended trochanteric osteotomy, and bone healing was achieved by the final follow-up. Conclusion: The modular tapered stem reviewed in this study was very versatile, could be used in most femoral revision cases, and allowed for rapid bone reconstruction. However, a long-term follow-up study is needed to confirm these results.
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