Primary Total Hip Arthroplasty with Use of the Modular S-ROM Prosthesis. Four to Seven-Year Clinical and Radiographic Results*

Modular Femoral Sleeve and Stem Implant Provides Long-term Total Hip Survivorship

“…In this study, there were no cases of osteolysis occurring distal to the metaphyseal sleeve. Similar findings have been reported in the literature, with virtually all cases of osteolysis being proximal to the distal extent of the porous-coated sleeve [2,7]. Only Cameron et al [5] have reported the appearance of osteolysis distally in two of their 491 (0.4%) patients followed for a mean of 11.5 years.…”

“…The ability of this hip system to prepare and fill the proximal and distal portions of the femur independently of each other is likely a major contributing factor for the intimate proximal sleeve-cortical bone contact and the resultant bone ingrowth observed in all cases. Other studies report high survivorship of the S-ROM 1 stem at early followup [3,4,7,18], but only three previous studies [1,2,5] have evaluated the outcome of this stem at a mean followup of at least 10 years. Biant et al [2] reported a 0% aseptic loosening in 55 THA at 10 years, Cameron et al [5] had a 0.4% aseptic loosening in 491 hips at 11 years, and Adamany et al [1] reported no cases of aseptic loosening in 34 hips at 12 years.…”

“…Furthermore, there were no cases of osteolysis isolated to or arising from the junction of the stem and the proximal porous-coated sleeve or radiographic evidence of metallosis at this site. Christie et al [7] reported femoral osteolysis occurred in 5.7% of 175 S-ROM 1 femoral implants at a mean followup of 5 years, while Biant et al [2] reported an osteolysis rate of 18% in 55 S-ROM 1 THAs at 10-year followup.…”

Can a Conical Implant Successfully Address Complex Anatomy in Primary THA? Radiographs and Hip Scores at Early Followup

“…The patients in this study should comparable improvement in their hip scores compared to previous reports of patients who underwent complex, primary, cementless, total hip arthroplasty with conical prostheses as well as modular prostheses [1,2,6,8,11,15,19,27,28,30,31]. Despite predictable success with similar stems, it remains critically important to systematically report clinical and radiographic results whenever new technology is introduced.…”

“…The optimal stem design in these patients is unknown. A number of studies have reported that modular prostheses such as the S-ROM (DePuy, Inc) can help deal with these anatomical challenges [2,5,6,11,19,30]; however, a theoretical disadvantage includes the potential for metal corrosion with modularity [9,20]. The Wagner Cone stem can accommodate small or deformed femora because of its proximal conical, tapered design.…”