RESUMO
PURPOSE: Here we report the short-term clinical and radiological results of the Profemur®-R cementless modular revision stem. METHODS: Between June 2002 and May 2006, 68 revision hip arthroplasties were consecutively performed using this stem. Survival at a mean follow-up of 5.2 years was 94%. According to the Paprosky classification, the femoral defect was classified as type 1 in 39 hips (57.3%), type 2 in 18 hips (26.5%), type 3A in ten hips (14.7%) and type 3B in one hip (1.5%). RESULTS: The Harris Hip Score was 49.57 before surgery and averaged 78.28 at the latest follow-up. The Merle d'Aubigne score improved from 9.15 preoperatively to 14.30 postoperatively. Stem stability rated according to the Agora Roentgenographic Assessment (ARA) scoring system averaged 5.22, suggesting a high likelihood of a durable implant. CONCLUSION: The revision prosthesis examined in this study can be considered a viable and useful option in revision hip arthroplasty, even in patients with bony femoral defects.
Assuntos
Artroplastia de Quadril/instrumentação , Cimentação/métodos , Prótese de Quadril , Desenho de Prótese , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Avaliação da Deficiência , Feminino , Nível de Saúde , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/fisiopatologia , Articulação do Quadril/cirurgia , Humanos , Complicações Intraoperatórias , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Radiografia , Recuperação de Função Fisiológica , Reoperação , Taxa de Sobrevida , CaminhadaRESUMO
We retrospectively reviewed 107 patients with 108 malignant or locally aggressive bone tumours treated between 1978 and 2009 by extracorporeal irradiation with 300 Gy to eradicate the tumour, and reimplantation of the bone as an orthotopic autograft. Patient subgroups were defined according to resection type. We describe the local recurrence rate, the graft infection rate and the factors affecting graft healing and graft survival. No local recurrences were detected in the irradiated grafts. At five-year follow-up, graft healing had occurred in 64% of patients, providing a stable and lasting reconstruction. For various reasons, 11% of grafts were removed, although no single factor was predictive of failure. All patient subgroups had comparable results. Early infection predicted the development of pseudarthrosis. Pelvic reconstructions had a worse graft survival. Rigid fixation and bridging of the graft appeared to be important technical points.