Augmenting Osteointegration of Proximal Femoral Endoprosthesis Using Porous Titanium Bridging Endosteal Collars: preliminary medium-term results

Abstract Background Aseptic loosening remains a major cause for failure of proximal femoral replacements (PFR). To reduce the incidence of aseptic loosening a PFR was developed with a selective laser sintered, porous titanium-bridging collar and endosteal component. This study reports the short-term outcomes of this implant in a consecutive series of patients. Methods Between October 2017 and August 2019, 24 patients, mean age 69 years (50–84) were managed using this PFE for a variety of aetiologies (10 oncological, 10 revision of aseptic loosening, 3 fracture non-union, and 1 for prior infected joint replacement). Patients were followed up at a mean of 24 months (16–34) with a clinical and radiographic assessment. Results Twenty-three patients were available for follow-up with one death in the early postoperative period. One patient died 18 months post-surgery due to causes unrelated to surgery, two cases of superficial infection were managed with antibiotics and two cases of deep infection managed with debridement, antibiotics, and implant retention (DAIR). At the last follow up the mean Harris Hip Score was 78 (68–86) and the mean Musculoskeletal Tumour Society Score was 20 (16–24). The radiographic assessment did not reveal any evidence of loosening with the integration of the endosteal collar observed in all cases. Conclusions Our medium-term results demonstrate good functional outcomes with no evidence of radiographic loosening and osteointegration of the endosteal collar in a consecutive series of patients. Further studies are required to assess the mid to long-term outcomes seen with this implant. Level of Evidence: Level IV – Retrospective Case Series