This Mayo Clinic retrospective study of 519 aseptic revision THAs asks whether modular fluted tapered stems provide reliable fixation and durable functional outcomes across the full spectrum of preoperative femoral bone loss, using Kaplan-Meier survivorship, Harris hip scores, and radiographic subsidence analysis over a mean 4.5-year follow-up (range 2–14 years).
When planning femoral revision in a hip with severe proximal bone loss (Paprosky 3B or 4), a modular fluted tapered stem is a reliable choice — this series shows fixation success is independent of bone-loss category, unlike extensively porous-coated stems whose outcomes degrade with worsening bone stock.
Counsel patients that early subsidence up to 5 mm is common and usually self-limiting, but intraoperative fracture risk (~13%) warrants prophylactic cerclage before reaming.
This Mayo Clinic retrospective study of 519 aseptic revision THAs asks whether modular fluted tapered stems provide reliable fixation and durable functional outcomes across the full spectrum of preoperative femoral bone loss, using Kaplan-Meier survivorship, Harris hip scores, and radiographic subsidence analysis over a mean 4.5-year follow-up (range 2–14 years).
When planning femoral revision in a hip with severe proximal bone loss (Paprosky 3B or 4), a modular fluted tapered stem is a reliable choice — this series shows fixation success is independent of bone-loss category, unlike extensively porous-coated stems whose outcomes degrade with worsening bone stock.
Counsel patients that early subsidence up to 5 mm is common and usually self-limiting, but intraoperative fracture risk (~13%) warrants prophylactic cerclage before reaming.