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The excellent long-term results of cemented collarless polished taper stems for primary and revision hip arthroplasty can be extended even further by cement-within-cement exchange, which preserves the femur.
The mechanical effects that polished taper stems impart on cement at the cement-bone interface probably contribute to their good long-term fixation and excellent clinical outcome.
It is worth noting that all except 1 of the stems revised were Exeter polished taper stems, and all were revised to Exeter stems (long or standard size).
The polished stem was the collarless polished taper stem (CPT stem; Zimmer, Warsaw, IN) tapered in the coronal and sagittal planes and with a surface roughness of 0.1 μm or less.
This suggests that stem subsidence without cement fracture observed in clinical practice, a phenomenon specific to polished taper stems (Fowler et al. 1988, Howie et al. 1998, Yates et al. 2002, Williams et al. 2002, Ek and Choong 2005), may be attributable to cement creep (Weightman et al. 1987).
The good long-term results of polished taper stems are probably attributable to the preservation of the proximal femoral cortex and such stems are associated with a low incidence of radiolucent lines in the proximal femur (Fowler et al. 1988, Wroblewski et al. 2001, Yates et al. 2002).
Similar(54)
This study highlights a specific fracture pattern that occurs with cemented well-fixed polished, tapered, collarless (PTC) stems.
In cemented total hip arthroplasty (THA), a polished tapered femoral stem with a design based on the taper-slip concept enables extremely reliable and durable fixation.
Stems in the latter category have a collarless, polished, tapered (CPT) design and subside into the cement mantle, creating hoop stresses.
We report the outcome of 58 consecutive polished tapered stems in 47 patients younger than 50 years, with a minimum of 10 years of follow-up.
We used the cemented CPT stem (Zimmer Inc., Warsaw, IN), which is a collarless, polished, tapered femoral stem in chrome-cobalt alloy with a 12/14 head taper.
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