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Femoral revision in total hip arthroplasty using a cementless modular stem: clinical and radiological results with a 8-year follow-up.
Spranz, David; Skrobek, David; Randoll, Jannis; Kinkel, Stefan; Merle, Christian; Walker, Tilman; Renkawitz, Tobias; Reiner, Tobias.
Afiliação
  • Spranz D; Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200 a, 69118, Heidelberg, Germany.
  • Skrobek D; Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200 a, 69118, Heidelberg, Germany.
  • Randoll J; Orthopaedicum Darmstadt, Rheinstraße 19, 64283, Darmstadt, Germany.
  • Kinkel S; ARCUS Sportklinik Pforzheim, Rastatterstraße 17-19, 75179, Pforzheim, Germany.
  • Merle C; Department of Orthopedic and Trauma Surgery, Paulinenhilfe, Diakonieklinikum Stuttgart, Rosenbergstraße 38, 70192, Stuttgart, Germany.
  • Walker T; Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200 a, 69118, Heidelberg, Germany.
  • Renkawitz T; Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200 a, 69118, Heidelberg, Germany.
  • Reiner T; Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstraße 200 a, 69118, Heidelberg, Germany. Tobias.Reiner@med.uni-heidelberg.de.
Arch Orthop Trauma Surg ; 144(3): 1369-1377, 2024 Mar.
Article em En | MEDLINE | ID: mdl-37872437
ABSTRACT

INTRODUCTION:

Modular femoral components allow for patient-specific restoration of hip joint geometry and the reconstruction of extensive bone defects in revision total hip arthroplasty (THA); however, potential problems of modular implants such as taper corrosion and the risk of implant fracture continue to be of concern. The aim of the present study was to evaluate the clinical and radiological results of a cementless modular revision stem following revision surgery due to aseptic loosening and periprosthetic fracture and to assess patient-reported outcome measures (PROMs) in these patients at mid-term follow-up. MATERIALS AND

METHODS:

In this study, a consecutive cohort of 75 patients who underwent primary revision THA at our institution using a modular cementless stem design (MRP-TITAN stem) was retrospectively evaluated at a mean follow-up of 7.7 years. Kaplan-Meier survivorship analyses were performed with revision of the femoral component for any reason as the end point. The Harris-Hip Score, the UCLA Activity Score, the Forgotten Joint Score and the SF-12 Score were used for clinical assessment. We used the Wilcoxon signed rank test to compare pre- and postoperative clinical scores.

RESULTS:

Overall stem survival with the endpoint stem re-revision for any reason was 85.4% at a mean follow-up of 7.7 years (range 2.4-14 years). Stem survival was 89.5% in the aseptic loosening group and 78.3% in the periprosthetic fracture group with no statistically significant difference between both groups (p = 0.107). One patient had to be revised due to taper fracture. PROMs improved significantly up to the latest follow-up, and radiographic evaluation showed full osseointegration of all stems in this cohort.

CONCLUSIONS:

Revision THA using a modular cementless titanium revision stem demonstrated adequate clinical and radiological results at mid- to long-term follow-up in this cohort. Cementless revision stems are a useful treatment option to restore the anatomy, especially in deformed hips and in complex revision hip arthroplasty. However, there are some significant disadvantages related to an increased risk of mechanical failure such as corrosion/fretting damage and implant fracture. Future high-quality prospective studies with longer follow-up are necessary to confirm the supposed advantages.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Fraturas Periprotéticas / Prótese de Quadril Limite: Humans Idioma: En Revista: Arch Orthop Trauma Surg Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Fraturas Periprotéticas / Prótese de Quadril Limite: Humans Idioma: En Revista: Arch Orthop Trauma Surg Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha
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