• Peter Moriarty, Georges Vles, Fares Haddad, and Sujith Konan.
• Department of Trauma and Orthopaedics, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2BU, UK.
• Arch Orthop Trauma Surg. 2021 Jun 1; 141 (6): 1065-1071.

PurposeA new fluted, titanium, monobloc stem with a three degree taper has been designed in an attempt to overcome the challenges associated with femoral reconstruction in the setting of extensive bone loss. The aim of this study was to report its early clinical and radiographic outcomes.MethodsThis is a retrospective review of prospectively collected data carried out at a single institution between Jan 2017 and Dec 2019. Forty-three femoral revisions were performed using a new tapered, fluted, titanium, monobloc (TFTM) revision stem. Complications, clinical and radiographic data were obtained from medical records and a locally maintained database. Clinical outcomes were assessed using the Oxford Hip Score (OHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). All post-operative radiographs were analysed for subsidence, osteolysis and femoral cortical bone remodelling.ResultsMean follow-up was 24 months (range 8-42 months). Subsidence of 1.2 mm was noted in one patient. No cases of clinically significant subsidence (> 10 mm) were observed. At final follow-up, a statistically significant improvement was noted in functional outcome scores. The mean OHS preoperatively and at final follow-up were 24 (SD 13) and 42 (SD15). p = 0.04 mean difference 18 (95% CI 15-22). The mean WOMAC scores preoperatively and at final follow-up were 62 (SD23) and 88 (SD7) respectively (p < 0.001, mean difference 26; 95% CI 21-34). No stem fractures were noted within the follow-up period.ConclusionPositive early clinical and radiological outcomes have been observed with this tapered, fluted, titanium, monobloc stem. Based on these results, this implant may be considered as a viable option in the majority of uncemented femoral revisions.

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