# Long-term survival outcomes of Wagner™ conical stems in crowe non-IV hip dysplasia: a retrospective analysis

## TL;DR

This study shows that Wagner™ conical stems used in hip surgery for non-IV developmental dysplasia have high long-term survival and good functional outcomes.

## Contribution

The study provides long-term survival data for Wagner™ conical stems in Crowe non-IV DDH patients.

## Key findings

- The 10-year survival rate was 95.7%, and the 20-year survival rate was approximately 80.5%.
- 86.3% of hips with retained implants achieved a Modified Harris Hip Score greater than 70.
- The main causes of failure were aseptic loosening, infection, and recurrent dislocation.

## Abstract

Total hip arthroplasty (THA) is one of the most frequently performed orthopedic procedures. Developmental dysplasia of the hip (DDH) presents specific anatomical challenges that require tailored implant designs. Wagner™ conical stems were developed to address the morphological alterations of dysplastic femur, offering potential advantages in stability and functional restoration. This study assesses the long-term survival and clinical outcomes of Wagner™ conical stems in patients with Crowe non-IV DDH.

This retrospective study included primary THAs performed between 2003 and 2015 using Wagner™ conical stems exclusively in patients with DDH. Only cases with complete clinical and radiographic follow-up were analyzed, excluding those lost to follow-up or revised. The evaluated outcomes were prosthetic survival rate, clinical performance assessed with the Modified Harris Hip Score (mHHS), and radiographic findings at final follow-up.

Forty-five patients (57 hips) met the inclusion criteria. The mean age at surgery was 56.5 years (range, 33–76), with a mean follow-up of 15 years (range, 8–20). Kaplan–Meier analysis showed a survival rate of 95.7% at 10 years and approximately 80.5% at 20 years, with an overall survival rate of 89.5% at the final follow-up. The main cause of failure was aseptic loosening, followed by infection, recurrent dislocation, and metallosis. Among hips with retained implants, 86.3% (44/51) achieved an mHHS > 70, indicating satisfactory functional recovery. The mean mHHS was 88.6 ± 14.3 (Range, 62–100), with a median of 92 and a mode of 100.

Wagner™ conical stems provide durable fixation and favorable long-term functional outcomes in Crowe non-IV DDH, with high survival rates and low complication incidence over extended follow-up.