Uncemented Tapered Fluted Stems

Uncemented Tapered Fluted Stems

Robert T. Trousdale

Key Concepts

  • Uncemented tapered fluted stems can provide durable fixation during primary total hip arthroplasty.

  • These stems are relatively simple to use as they require only reaming the canal until one achieves axial and rotational stability.

  • These stems are especially helpful in the face of excessive femoral version, coxa valga, and small femurs and in posttraumatic deformity (Figure 10.1).

Sterile Instruments and Implants

  • Routine hip retractors.

  • System specific tapered reamers to prepare canal.

  • System specific tapered trial implants.

  • Trial heads including 28 and 22 mm, as some of these patients will have very small acetabular components.

Surgical Approaches

  • Surgical approach may be according to surgeon preference. This implant may be placed easily by various anterior, lateral, or posterior approaches.

  • Drape the whole or a majority of femur.

  • Position such that it is easy to get an intraoperative radiograph if desired.

Preoperative Planning

  • Know patient’s preoperative leg length discrepancy.

  • Template cup size and position.

  • Template femoral component size on anteroposterior and lateral radiographs of the femur. Template the desired neck resection level.

  • Using the tip of trochanter as a secondary check for anticipated neck resection is helpful. In general, the tip of greater trochanter should be at the level of the center of the femoral head.

Bone/Implant/Soft Tissue Techniques

  • Perform desired approach to hip joint.

  • Perform femoral neck osteotomy according to the preoperative plan.

  • Prepare acetabulum, place cup with trial liner.

    Figure 10.1 ▪ Anteroposterior radiograph of patient with left hip arthritis with proximal femoral deformity. Femur is in varus as well as has torsional malunion deformity.

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    Dec 14, 2019 | Posted by in ORTHOPEDIC | Comments Off on Uncemented Tapered Fluted Stems
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