Revision total hip arthroplasty in Paprosky II and IIIA femoral bone defects. Using modular uncemented stems with proximal fixation

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Published: May 11, 2016
DOI: https://doi.org/10.15417/511
Keywords:
revisión THA, modular uncemented femoral stem, proximal fixation, off-set, leg length discrepancy, joint stability.

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German Garabano
Hospital Britanico de Buenos Aires
http://orcid.org/0000-0001-5936-0607
Diego Sebastian Mana Pastrián
Hospital Británico de Buenos Aires.
http://orcid.org/0000-0003-3714-2777
Hernán del Sel
Hospital Británico de Buenos Aires.
http://orcid.org/0000-0002-3655-1408

Abstract

Background: The purpose of this retrospective analysis was to observe the outcomes of a modular hip system (S-ROM®, Depuy Warsaw, Ind) in RTHA with Paprosky femoral bone deficit II and IIIA, evaluating their performance, off-set restoration and leg length discrepancy correction. Methods: We analyzed 22 RTHA in 22 patients, 12 women and 10 men, with an average age of 62.38 years. The average follow-up was 62 months. Paprosky femoral bone defict were 15 type II and 7 IIIA. Clinical evaluation was through the Harris Hip Score and stem fixation through the Engh classification. Offset restoration, leg length discrepancy (considered as correct a difference of less than 5 mm) and hip stability, were evaluated radiographically.Results: Offset was properly restored in 16 (72,3%) cases and the leg length was matched in 15 (68,2%). There was a single stem subsidence and proximal bone ingrowth fixation was obtained in 17 (77,27%) patients. There were 7 (31.8%) complications: two dislocations that required revision, 4 intraoperative undisplaced fractures of the proximal femur and one lateral popliteal nerve paresis that resolved spontaneously.Conclusion: S-ROM modular system seems to be a valid alternative to solve a complex problem. It provides proximal fixation when bone stock is not available, and its versatility allows to optimize hip stability, leg length equalization and offset restoration in revision THA with femoral bone defects, showing an acceptable complication rate for this kind of surgery. 

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How to Cite
Garabano, G., Mana Pastrián, D. S., & del Sel, H. (2016). Revision total hip arthroplasty in Paprosky II and IIIA femoral bone defects. Using modular uncemented stems with proximal fixation. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 81(2), 115-121. https://doi.org/10.15417/511
Issue
Vol 81 No 2 (2016)
Section
Clinical Research
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Author Biographies

German Garabano, Hospital Britanico de Buenos Aires

Médico de planta de miembro inferior en el Hospital Británico de Buenos Aires.

Diego Sebastian Mana Pastrián, Hospital Británico de Buenos Aires.

Especialista en Cadera y Rodilla. Medicina Deportiva. Hospital Británico.

Hernán del Sel, Hospital Británico de Buenos Aires.

Jefe de Servicio del Hospital Británico de Buenos Aires.

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