The use of a cementless tapered stem in young patients affected of secondary hip arthritis

Abstract

Introduction: The Wagner cone stem was designed for uncemented hip arthroplasty in difficult proximal femoral conditions or femoral deformities. The most common indications for the use of this stem are secondary hip arthritis due to developmental hip dysplasia, septic arthritis or congenital malformations. We present a case series of patients that underwent hip arthroplasty with the use of a Wagner cone stem. Materials and methods: A retrospective chart review of 17 patients (15 women and 2 men) was performed with a mean age of 39 (25-62). Clinical evaluation was rated with the Merlé D´Aubigné score. Radiographic evaluation consisted in antero posterior and axial views of the hip. One patient was operated bilaterally, with a total of 18 hips operated, and mean follow up of 8 years (5-12). Results: Diagnosis of secondary arthritis was: developmental hip dysplasia in 12 patients, septic arthritis sequelae in 3 patients and other causes of hip arthritis in 3 patients. Average Merlé-D´Aubigné score was 9,9 (8-13) preoperatively and 16,10 (13-18) at last follow-up. One patient presented crural nerve paresia after surgery, which was recovered completely and one stem was reviewed due to aseptic loosening. Discussion: The Wagner cone stem has successfully resolved cases with abnormalities in the proximal femur in patients with secondary hip arthritis. Although this procedure is not exempt of complications, it has shown good stability which translates into good results in the medium to long term.