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

Background: 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. Materials and methods: 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. Results: 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 (Formula presented.) 14.3 (Range, 62–100), with a median of 92 and a mode of 100. Conclusion: 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.