Results of a cemented straight titanium alloy femoral stem after mean follow-up of 13 years

The first consecutive series of 250 implantations of a cemented femoral shaft prosthesis made of titanium alloy (Bicontact®, Aesculap, Tuttlingen, Germany) in 239 patients are included in this prospective follow-up study. Average time of follow-up evaluation was 12.6 years (range 11.8–13.8 years). At follow-up, 116 patients with 112 hips have died and only two could not be located. Follow-up rate was 99.2% for the patients still alive at time of follow-up evaluation. Eight patients have been revised, two for infection, one for aseptic loosening of a varus-malaligned stem and two for aseptic loosening in cases with osteolysis; two radiologically well-fixed stems had been revised during acetabular revision. Two additional stems were regarded loose according to radiologic criteria. Survival estimate (with revision as an endpoint) showed a calculated cumulative survival rate of 95.8% after 14 years [confidence limits: 98.0% (upper) and 91.4% (lower)]. The average HARRIS hip score at time of follow-up was 77.3 points. Radiologically, signs of loosening could be detected in two stems: in both cases osteolyses developed together with significant polyethylene wear. One of these patients experienced severe pain, so an indication for revision is given, the other has only mild pain and revision had not been indicated so far. In conclusion, the long-term follow-up results with this cemented titanium femoral component are encouraging and are comparable to other successful cemented femoral components in primary total hip arthroplasty. No increased risk for aseptical loosening was associated with the combination of titanium and cement in this specific stem.