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 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, three days to nine years).

Results: The cumulative incidence of reoperation was 6.1% (95% CI [confidence interval]: 2.5 to 12) at two years. Causes of reoperation were periprosthetic fracture (3), dislocation (1), periprosthetic joint infection (PJI) (1), and symptomatic hardware (1). Only the PJI 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 more underwent revision THA through a direct anterior approach (33.3 versus 2.8%, P = 0.027).

Conclusion: In patients 75 years and older undergoing aseptic revision THA with MFT stems, the cumulative incidence of reoperation was 6.1% at two years. The MFT stem remains an acceptable option in older patients undergoing aseptic revision THA.

Keywords: elderly; modular fluted tapered stems; revision total hip arthroplasty.

Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

背景： 模块化槽纹锥形（MFT）股骨柄在翻修全髋关节置换术（THA）中变得越来越流行，因此了解这些股骨柄的临床效果，特别是对老年人群的效果尤为重要。很少有研究针对这一人群进行过探讨。本研究旨在报告接受无菌性翻修THA并使用MFT股骨柄的老年患者再次手术的发生率。

方法： 分析了2015年6月1日至2020年12月31日期间98名75岁及以上的接受无菌性翻修THA并使用MFT股骨柄的患者的前瞻性队列。通过查阅医疗记录确定需要进入手术室进行髋关节再手术的患者，定义任何原因导致需要进入手术室的情况为再次手术。利用死亡作为竞争事件的累积发病率图来可视化再手术的发生情况。中位随访时间为4.5年（范围从三天到九年）。

结果： 两年内的再手术累积发生率为6.1% (95% CI [置信区间]：2.5至12)。再次手术的原因包括假体周围骨折(3例)，脱位(1例)，假体周围关节感染(PJI)(1例)，以及有症状的内植物(1例)。仅PJI病例需要对MFT股骨柄进行再翻修。没有出现无菌性松动的情况。接受再次手术的患者的年龄更小（77岁对比81岁，P = 0.037），并且更多患者通过直接前侧入路进行了翻修THA (33.3% 对比 2.8%，P = 0.027)。

结论： 对于接受无菌性翻修THA并使用MFT股骨柄的75岁及以上的患者，两年内的再手术累积发生率为6.1%。在老年患者中进行无菌性翻修THA时，MFT股骨柄仍然是一个可接受的选择。

关键词： 老年人；模块化槽纹锥形股骨柄；翻修全髋关节置换术。

版权所有 © 2025 The Author(s)。Elsevier Inc.出版。保留所有权利。