Revision Total Hip Arthroplasty with a Porous-coated Modular Stem: 5 to 10 Years FollowupLakstein, Dror, MD1, a; Backstein, David, MD, MEd, FRCSC1; Safir, Oleg, MD, FRCSC1; Kosashvili, Yona, MD, MHA1; Gross, Allan, E., MD, FRCSC1
The ZMR® porous stem is a modular cylindrical porous-coated femoral stem for revision THA. The objective of this study was to evaluate the clinical and radiographic outcomes of this stem at midterm followup. We prospectively reviewed 69 patients (72 femoral revisions) treated with the stem. The indication for revision was aseptic loosening in 61 (85%), periprosthetic fractures in five (7%), infection in three (4%), dislocation in two (3%), and fractured stem in one (1%). Minimum followup was 60 months (mean, 85 months; range, 60-114 months). The survival rate with revision for any reason as an end point was 93.8%. Mean preoperative Harris hip score was 39 points, and mean Harris hip score at last followup was 72 points. Four (5.5%) stems required rerevision, two (2.8%) for loosening, one (1.4%) for fracture at the modular junction, and one (1.4%) for infection. Subsidence occurred in eight (11%) patients, in the range of 5 to 25 mm. Two (2.89%) of the stems that subsided were symptomatic and progressive. The ZMR® porous stem is a versatile system that offers a reliable fixation and an off-the-shelf solution for a multitude of femoral reconstruction challenges.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.