Document Detail


High Survival of Modular Tapered Stems for Proximal Femoral Bone Defects at 5 to 10 Years Followup.
MedLine Citation:
PMID:  22948527     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Currently, the two most commonly used options for the revision of femoral components in North America are: cylindrical, nonmodular, cobalt-chromium stems and tapered, fluted, modular, titanium (TFMT) stems. Previous reports have cited high failure rates with cylindrical cobalt chrome stems in large femoral defects but the longer term survival of the fluted stems is unknown. QUESTIONS/PURPOSES: We examined the 5- to 10-year survival of TFMT stems implanted for severe femoral defects. METHODS: We reviewed all 65 patients with severe proximal bone defects revised with the TMFT stem between January 2000 and 2006. Ten were lost to followup and seven were dead, leaving 48 patients for followup at 5 to 10 years (mean, 84 months; range, 60-120 months). All patients completed five quality-of-life (QOL) questionnaires. Radiographs were evaluated for loosening, subsidence, and preservation of proximal host bone stock. RESULTS: Implant survivorship was 90%. No patient underwent revision for either subsidence or loosening. Subsidence occurred in seven patients (average, 12.3 mm) but all achieved secondary stability. Five patients underwent revision as a result of fracture of the stem and all had the original standard stem design, which has since been modified. All five implant fractures occurred at the modular stem junction. Mean QOL outcomes were: WOMAC = 81 (pain), Oxford = 75, SF-12 = 54 (mental) and 38 (physical), UCLA Activity = 4, and satisfaction overall = 73. CONCLUSIONS: Midterm survivorship of modular titanium stems in large femoral defects is high; however, ongoing surveillance of stem junctional fatigue life is required. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Authors:
Andrew P Van Houwelingen; Clive P Duncan; Bassam A Masri; Nelson V Greidanus; Donald S Garbuz
Related Documents :
8116207 - Endoscopically assisted annular ligament release in horses.
7975057 - Carpal conformation in relation to carpal chip fracture.
511737 - A review of third phalanx fractures in the horse: sixty-five cases.
2809817 - Plasma lidocaine levels following hematoma block for distal radius fractures.
20733427 - Salter-harris type iii fractures of the distal femur: plain radiographs can be deceptive.
17667107 - Delayed orbital subperiosteal hemorrhage after blunt trauma.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-5
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Orthopaedics, University of British Columbia, Room 3114, 910 West 10th Avenue, Vancouver, British Columbia, V5Z 4E3, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Reliability of lower-limb alignment measurements in patients with multiple epiphyseal dysplasia.
Next Document:  Acetabular Cup Design Influences Deformational Response in Total Hip Arthroplasty.