The incidence of femoral component revisions following total hip arthroplasty (THA) continues to rise at an unsustainable rate globally. To achieve a stable and durable femoral reconstruction, revision surgery demands specialized implants that can reliably bypass proximal bone defects left behind by the removal of failed primary components. Compared to the rigid, fully porous-coated cylindrical stems used historically, contemporary modular tapered, fluted titanium (TFT) stems have rapidly emerged as the global gold standard. This reputation is built on their immense surgical versatility, reduced stress shielding, and near-immediate axial and rotational stability.
However, achieving definitive biological osseointegration is completely dependent on early mechanical stability. A lack of structural interlock can cause the femoral component to migrate dynamically, resulting in early component subsidence, leg-length discrepancies, and severe mechanical failure. While predictors of implant migration are well documented in primary settings, there is a profound lack of non-registry data exploring the specific behavioral parameters and risk factors for subsidence within a dedicated cohort of aseptic revision revisions. We set out to investigate the true structural incidence and multivariable predictors of early TFT stem subsidence.
