The Short and "Shorter" of It: >1750 Tapered Titanium Stems at 6-to 88-Month Follow-Up

Introduction: Femoral fixation in THA can be achieved with different design rationales. Our hypothesis was that two short titanium flat-tapered stems would demonstrate similar stability. Methods: Between May 2005 and May 2012, 849 short (135-170 mm), titanium flat stems ("Short") were used in THA. Between July 2005 and May 2012, 902 similar, but 35-mm shorter, stems ("Shorter") were utilized. Harris Hip Score, radiographic, and survivorship data were analyzed. Results: Survivorship of the "Short" stems was 99.1% at 7 years. Eight of 849 stems have been revised: 4 for loosening, 3 for fracture, and 1 for infection. Harris Hip Score improved from 41.6 to 88.9. In the "Shorter" group, 9 of 902 have been revised: 6 for fracture/loosening, 2 for infection, and 1 for instability. HHs improved from 43.7 to 92.0. No statistically significant differences were noted in revision rate. Conclusion: This comparison study of short titanium tapered stems has confirmed similar >99% survivorship in >1750 THA stems at 6-to 88 (mean 36)-month follow-up. Early periprosthetic fracture, although rare (0.5%), was more likely to occur in older patients. (C) 2013 Elsevier Inc. All rights reserved.