Document Detail


Complex revision total hip arthroplasty with modular stems at a mean of 14 years.
MedLine Citation:
PMID:  17891035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively reviewed 87 patients (92 hips) who had revision hip surgery to determine whether a proximally coated, modular femoral component would remain stably fixed at long-term followup. Thirteen patients died and 12 patients were lost to followup leaving 62 patients (67 hips) available for review with minimum followup of 8 years (mean, 14 years; range, 8-17 years). Preoperative radiographs were reviewed using Paprosky's classification. Postoperative radiographs were reviewed for osteolysis, endosteal hypertrophy, cortical hypertrophy, distal pedestals, component breakage, and loosening. Thirty-seven hips underwent femoral allografting, 10 of which were proximal femurs. With revision as the endpoint the Kaplan-Meier survivorship (including deaths and loss to followup) was 60% at 14 years. Forty-seven of the 57 (82%) noncemented stems were bone ingrown. All had relative proximal bone preservation and 33 of 57 (58%) had bone hypertrophy in the diaphysis around zones 2 and 6. There were five aseptic failures (9%). Each of those was Paprosky Class IIIB or IV preoperatively. There were no long-term failures in Paprosky Class II or IIIA. The aseptic failures have been re-revised. This modular stem resulted in reliable fixation with relative preservation of proximal bone stock at this intermediate interval in complex revisions in Paprosky Class II and IIIA. Paprosky Class IIIB and IV defects may need additional component fixation options.
Authors:
Joseph C McCarthy; Jo-Ann Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  465     ISSN:  0009-921X     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-28     Completed Date:  2008-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  166-9     Citation Subset:  AIM; IM    
Affiliation:
New England Baptist Hospital, Boston, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
Arthroplasty, Replacement, Hip / adverse effects,  instrumentation*
Bone Transplantation / methods*
Femur / radiography,  surgery*
Follow-Up Studies
Hip Joint / physiopathology,  radiography,  surgery*
Hip Prosthesis*
Humans
Joint Instability / etiology,  prevention & control
Osseointegration
Osteolysis / etiology,  physiopathology,  surgery*
Prosthesis Design
Prosthesis Failure*
Reoperation
Retrospective Studies
Stress, Mechanical
Time Factors
Titanium*
Treatment Outcome
Chemical
Reg. No./Substance:
7440-32-6/Titanium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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