Modular Cementless Femoral Stem in Complex Primary Total Hip
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The S-ROM® hip is a well-known and flexible prosthesis with a wide range of metaphyseal and diaphyseal geometries that can be used in a number of surgical scenarios. The aim of this study was to look at the long-term outcomes of complex primary complete hip arthroplasty (THA) with a modular cementless stem (S-ROM).

Retrospective consecutive study included 167 patients (167 hips); 97 males and 70 females with average age at time of surgery of 55 years (range 22-76). All patients underwent complex THA. Patients were identified using a prospective database. All patients received a cementless acetabular component with a standard polyethylene liner. The primary outcome measure was survivorship beyond 15 years using stem revision for any cause as an end point. Secondary outcome measure was rate of radiographic loosening using Engh classification.

--Only 3 patients required stem revision for aseptic loosening and one for periprosthetic fracture.

--Isolated acetabular revision was undertaken in 23/167 patients (13.8%) due to polythene wear, osteolysis and aseptic loosening.

--Proximal femoral stress shielding (zone 1, 7) was noted in 34/167 hips (20.4%).

--Stable bony ingrowth was noted in 144 hips (86.2%) and the remaining 23 hips had stable fibrous ingrowth (13.8%).

--Using stem ‘any cause revision’ as an end-point, the mean stem survivorship was 31.5 years (95% CI; 31.007 to 31.985) with 30 years estimated survivorship of 97.6%.

Conclusively, In a single designer surgeon series, S-ROM stem has stood the test of time with long-term 30 years survivorship of 97.6% and continues to play an important role in modern hip surgery providing longevity and versatility.