BACKGROUND Modular fluted tapered (MFT) femoral components are frequently utilized in aseptic revision total hip arthroplasties (THAs). However, long-term follow-up has been limited. The purpose of this study was to update our prior series at long-term follow-up, with specific emphasis on implant survivorship, radiographic results, and complications in a large cohort of aseptic revision THAs using MFT stems. METHODS We retrospectively identified 515 aseptic femoral revisions performed with 2 MFT stem designs in the total joint registry of a single tertiary care academic institution from 1999 to 2013. Serial radiographs were reviewed for subsidence of >5 mm. The mean follow-up (and standard deviation) was 10 ± 5 years (range, 2 to 21 years). A competing risk model accounting for death was utilized. RESULTS The 15-year cumulative incidence of any revision was 12%. There were 57 revisions, 27 of which involved revision of the fluted tapered component (FTC). Dislocation (n = 19), periprosthetic joint infection (n = 15), and aseptic loosening of the FTC (n = 11) were the most common reasons for revision. The 15-year cumulative incidence of any reoperation was 16%. The 15-year cumulative incidences were 6% for any FTC revision and 2% for FTC revision for aseptic loosening. Stem subsidence of >5 mm occurred in 2% of unrevised cases, and all but 1 stem was stable at the most recent follow-up. CONCLUSIONS This large series of MFT stems used in aseptic revision THAs had a 2% incidence of subsequent revision of the FTC for aseptic loosening at 15 years. Dislocation and infection were the most common reasons for any revision. LEVEL OF EVIDENCE Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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使用模块化凹槽锥形柄进行无菌翻修全髋关节置换术：515 例病例的长期随访。


背景技术模块化凹槽锥形(MFT)股骨部件经常用于无菌翻修全髋关节置换术(THAs)。然而，长期随访受到限制。本研究的目的是更新我们之前的长期随访系列，特别强调使用 MFT 柄进行无菌翻修 THA 的大型队列中的种植体存活率、放射学结果和并发症。方法 我们回顾性地确定了 1999 年至 2013 年间在一家三级医疗学术机构的全关节登记处采用 2 个 MFT 柄设计进行的 515 例无菌股骨翻修手术。对连续 X 线照片进行了检查，以确定是否有 >5 毫米的下沉。平均随访时间（和标准差）为 10 ± 5 年（范围：2 至 21 年）。使用了解释死亡的竞争风险模型。结果 15 年任何翻修的累积发生率为 12%。共有 57 项修订，其中 27 项涉及凹槽锥形部件 (FTC) 的修订。脱位 (n = 19)、假体周围关节感染 (n = 15) 和 FTC 无菌性松动 (n = 11) 是最常见的翻修原因。任何再次手术的 15 年累积发生率为 16%。任何 FTC 翻修的 15 年累计发生率为 6%，而 FTC 翻修的无菌性松动的 15 年累计发生率为 2%。 2% 的未修复病例中发生 >5 毫米的茎下沉，并且在最近的随访中，除 1 个茎外，所有茎均稳定。结论 用于无菌翻修 THA 的这一大系列 MFT 柄在 15 年时因无菌松动而进行 FTC 翻修的发生率为 2%。脱臼和感染是任何翻修的最常见原因。证据级别 治疗级别 III。有关证据级别的完整描述，请参阅作者须知。