Low Incidence of Reoperation of Modular Fluted Tapered Stems in Aseptic Revision Total Hip Arthroplasty in Patients 75 Years and Older

Background: Modular fluted tapered (MFT) stems have become popular in revision total hip arthroplasty (THA); therefore, it is imperative to understand the clinical outcomes of these stems, particularly in elderly patients, a population that has seldom been studied. This study aimed to report the cumulative incidence of reoperation among elderly patients who underwent aseptic revision THA with MFT stems. Methods: A prospective cohort of 98 patients aged 75 years and older who underwent aseptic revision THA with MFT stems between June 1, 2015, and December 31, 2020, was analyzed. Medical record review identified patients who underwent reoperation of the hip, which was defined as any cause requiring the operating room. A cumulative incidence plot with death as a competing event was used to visualize reoperation occurrence. The median follow-up was 4.5 years (range, 3 days to 9 years). Results: The cumulative incidence of reoperation was 6.1% (95% confidence interval: 2.5 to 12) at 2 years. Causes of reoperation were periprosthetic fracture (3), dislocation (1), periprosthetic joint infection (1), and symptomatic hardware (1). Only the periprosthetic joint infection case required re-revision of the MFT stem. There were no cases of aseptic loosening. Patients who underwent reoperation were younger (77 versus 81 years, P = 0.037), and most underwent revision THA through a direct anterior approach (33.3 versus 2.8%, P = 0.027). Conclusions: In patients, aged 75 years and older, undergoing aseptic revision THA with MFT stems, the cumulative incidence of reoperation was 6.1% at 2 years. The MFT stem remains an acceptable option in older patients undergoing aseptic revision THA.