Outcomes with use of a modular, cementless, tapered and fluted femoral prosthesis in revision hip arthroplasty with mid-term follow-up.

INTRODUCTION: Increasing demand for revision hip arthroplasty (rTHA), particularly among patients with longer life expectancy, necessitates durable femoral implants. The Link MP modular fluted tapered stem lacks granular mid- and longer-term outcome data. METHODS: A retrospective review of 125 rTHA procedures using the Link MP stem was conducted at a UK centre from 2011 to 2025. Demographics, operative details, complications, radiographic migration, and clinical outcomes were analysed, and Kaplan-Meier survival analysis assessed implant survivorship. RESULTS: Median follow-up was 57 months, with 100 followed up for at least 2 years. Aseptic loosening was the primary revision indication (n = 85, 68%). Extended trochanteric osteotomy (n = 71, 56.8%) and cortical windowing (n = 35, 28%) were common adjuncts, with 98.1% union rate across the osteotomy cohort. Median stem migration was 3 mm; 36% had >5 mm migration without correlation to reduced mobility (p = 0.273). Overall, 12 cases (9.6%) returned to theatre; stem-related reoperation occurred in 5 cases (4%). Infection was the most common reason for return to theatre (n = 4, 33.3%), with instability, fractures, and device issues also noted. Kaplan-Meier analysis showed 96% stem survival at 166 months (95% confidence interval from 89.1% to 100%, with 4 hips at risk at that period. 96 cases (76.8%) returned to baseline mobility, 7 (5.6%) of cases suffered an intraoperative complication. CONCLUSIONS: The Link MP stem demonstrates excellent survivorship in complex revision scenarios. Early stem migration appears benign. Mechanical complications at the modular junction were rare but clinically important, requiring return to theatre. This study supports the implant's reliability and provides technical insight into its use.