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This research evaluates the mid-term outcomes of tapered titanium femoral components in complex primary and revision total hip arthroplasty.

February 5, 2026Open Access

Five-year results of a monolithic tapered, fluted titanium femoral component in complex primary and revision total hip arthroplasty

Key Points

This research evaluates the mid-term outcomes of tapered titanium femoral components in complex primary and revision total hip arthroplasty.
Multi-institutional retrospective review of patients from July 2016 to June 2020.
Evaluation of pre-, intra-, and postoperative characteristics.
Assessment of all-cause, septic, and aseptic revisions over five years.
Utilization of Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) at various follow-up points.
Femoral component survivorship free from aseptic revisions was 99.1% at 5.1 years after surgery.
Aseptic revision occurred in only one patient (0.9%) due to a periprosthetic acetabular fracture.
Survivorship from septic revisions was 93.2% at 5.3 years.
All-cause survivorship from any revision was 92.4% at 5.3 years.
HOOS, JR scores improved significantly from 46.1 to 83.8 over five years.

Abstract

Aims Total hip arthroplasty (THA) in the setting of proximal femoral defects and poor bone stock often necessitates distal fixation using specialized implants, such as monolithic tapered, fluted titanium stems (TFTSs), to ensure adequate stability. This study evaluates the mid-term outcomes of TFTS in both primary and revision THA. Methods This was a multi-institutional retrospective review of patients who received monolithic TFTS between July 2016 and June 2020 during either complex primary THA or revision THA. Outcomes included pre-, intra- and postoperative characteristics, as well as five-year all-cause, septic and aseptic revisions, and Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) at different postoperative timepoints. Results A total of 115 patients with a mean follow-up of 6.3 years (SD 1.2) were included. Femoral component survivorship free from aseptic revisions was 99.1% (95% CI 97.3 to 100) at 5.1 years after TFTS. Aseptic revision occurred in a single patient (0.9%) due to periprosthetic acetabular fracture that necessitated femoral component removal for exposure 60.6 months following TFTS. Survivorship from septic revisions was 93.2% (95% CI 91.5 to 99.9) at 5.3 years. Septic revisions included debridement, irrigation and exchange of modular components (n = 3, 2.6%), and two-stage revision arthroplasties (n = 4, 3.5%) at a mean of 27.7 months after surgery (1.5 to 63.9). All-cause survivorship from any revision was 92.4% (95% CI 90.5 to 100) at 5.3 years after TFTS. HOOS, JR scores improved from preoperative to five-year follow-up (46.1 (SD 20.8) to 83.8 (SD 19.0), respectively). Conclusion The TFTS demonstrates excellent mid-term survivorship (99.1% at five years) and significant clinical improvement in complex primary and revision THA. These outcomes suggest that the TFTS can be considered a valuable option in this challenging patient population. Cite this article: Bone Jt Open 2026;7(2):138–147.

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