Clinical outcome of a fibermetal taper stem - Minimum 5-year followup

Tapered femoral components were designed to provide a cementless alternative in patients with narrow femoral canals. Major concerns with this stem include perioperative fracture and thigh pain. To ascertain the frequency of these concerns. we retrospectively reviewed 100 consecutive hips in 97 patients who underwent total hip arthroplasty with a tapered fibermetal femoral component. Patients were evaluated postoperatively using Harris hip scores and sequential radiographs. The average age of the patients was 56.5 years (range, 33.7-73.5 years). Minimum followup was 5 years (average. 6.2 years; range, 5-9 years). One patient died at 1.3 years and was excluded from the study. Six patients had incomplete perioperative fractures of the calcar without extension below the lesser trochanter. All fractures were recognized perioperatively and fixed with cerclage wires without further problems. Four patients underwent revision surgery, two for recurrent dislocation secondary to malpositioning of the acetabular cup, one for a greater trochanteric fracture after a fall, and one for a fractured zirconium femoral head. At last followup, the mean Harris hip score was 98 (range, 86-100); two patients had mild anterior thigh pain. All femoral stems appeared to have bony integration radiographically. Tapered femoral stems provide a cementless alternative in patients with a narrow femoral canal without undue risk of perioperative fracture or thigh pain.