Prospective evaluation of short and mid-term outcomes of total hip arthroplasty using the Accolade™ stem.

Purpose: Cementless press-fit total hip arthroplasty (THA) with the Accolade stem (Stryker AccoladeTM TMZF, Mahwah, New Jersey) has demonstrated variable implant survivorship and outcomes. The purpose of this study was to analyse the: 1) implant survivorship; 2) complications; 3) functional outcomes; 4) overall quality of life; and 5) patient expectations and satisfaction following THA with this particular press-fit stem.

Methods: A prospectively collected database of 222 patients who underwent THA at 7 institutions between 2006 and 2009 using the Accolade stem (Stryker Inc. Mahwah, New Jersey) was evaluated. Harris Hip Score (HHS) and SF-12 were used to assess the outcomes at 2- and 5-year follow-up. Kaplan-Meier survivorship was calculated at 5 years of follow-up.

Results: The 5-year aseptic and all-cause survivorship rates were 99.4% (95% CI, 96.3 to 99.9%) and 97.9% (95% CI, 94.6 to 99.2%), respectively. At 2 and 5 years postoperatively, the patients demonstrated a mean HHS of approximately 89 points and 92 points, respectively. The mental and physical components of the SF-12 mean score increased with the physical component having a more marked increase. The mental and physical components of the SF-12 score increased to a mean of 46 and 45 points at 2 and 5 years, respectively. At 2-year follow-up, over 90% of patients were satisfied with their outcome in a majority of areas surveyed.

Discussion: Our results suggest that the use of this press-fit construct results in tremendous improvements in functional and quality of life outcomes, along with excellent survivorship at short- and mid-term follow-up.