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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 12, 1567-1573.
doi: 10.1302/0301-620X.88B12.17796  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Long-term survival of a cemented titanium-aluminium-vanadium alloy straight-stem femoral component

S. Kovac, MD, Orthopaedic Surgeon1; R. Trebse, MD, Orthopaedic Surgeon1; I. Milosev, PhD, Senior Research Associate2; V. Pavlovcic, MD, PhD, Professor of Orthopaedic Surgery3; and V. Pisot, MD, Orthopaedic Surgeon1

1 Valdoltra Orthopaedic Hospital, Jadranska cesta 31, 6280, Ankaran, Slovenia.
2 Jozef Stefan Institute, Department of Physical and Organic Chemistry, Jamova 39, 1000 Ljubljana, Slovenia.
3 Department of Orthopaedic Surgery, University Medical Centre and University of Ljubljana, Zaloska, C. 7, 1000 Ljubljana, Slovenia.

Correspondence should be sent to Dr S. Kovac; e-mail: simon.kovac{at}ob-valdoltra.si

We present a retrospective series of 170 cemented titanium straight-stem femoral components combined with two types of femoral head: cobalt-chromium (CoCr) alloy (114 heads) and alumina ceramic (50 heads). Of the study group, 55 patients (55 stems) had died and six (six stems) were lost to follow-up. At a mean of 13.1 years (3 to 15.3) 26 stems had been revised for aseptic loosening. The mean follow-up time for stable stems was 15.1 years (12.1 to 16.6).

Survival of the stem at 15 years was 75.4% (95% confidence interval (CI) 67.3 to 83.5) with aseptic failure (including radiological failure) as the end-point, irrespective of the nature of the head and the quality of the cement mantle. Survival of the stem at 15 years was 79.1% (95% CI 69.8 to 88.4) and 67.1% (95% CI 51.3 to 82.9) with the CoCr alloy and ceramic heads, respectively. The quality of the cement mantle was graded as a function of stem coverage: stems with complete tip coverage (type 1) had an 84.9% (95% CI 77.6 to 92.2) survival at 15 years, compared with those with a poor tip coverage (type 2) which had a survival of only 22.4% (95% CI 2.4 to 42.4). The poor quality of the cement mantle and the implantation of an alumina head substantially lowered the survival of the stem.

In our opinion, further use of the cemented titanium alloy straight-stem femoral components used in our series is undesirable.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General