Extended porous femoral stems in hip revisions.
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Aug 6, 2016
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Abstract
Introduction: The porous coated cylindrical stem are one of the most popular option in the set of hip revison surgery. The poupose of this study is present the clinical and radiographic results of a group of patients treated with this stem.Material and Methods: Between 1997 and 2010, we retrospectively evaluated 150 stem in 148 patients. The indication for revisión was aseptic loosening in 88 cases (58.6%), septic loosening in 41 cases (27.3%), periprosthetic fracture in 14 cases (9.3%), failed hip ostesynthesis in 4 cases (2.6%) and stem fracture in 3 cases (2%). We followed the patient on average for 7.7 years.Results: We achived bone-ingrowth fixation in 135 patients (90 %,), fibrous tissue fixation in 12 (8%) and unstable fixation in 3 (2 %). The mean Harris hip score improved to 92 points at last follow-up. Three stem were revised (2%). One patient had revisión becouse of stem loosening. The other two becouse of deep infection required a 2 staged revision. Three patient (2%) had dislocation and was treated succesfully with closed reduction.Conclusion: The porous coated cylindrical stem is a predictable technique with excellent survival rates in the set of revisión hip surgery.
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Bruno, P., Bidolegui, F. M., Pereira, S. P., Allende, B. L., & Vindver, G. (2016). Extended porous femoral stems in hip revisions. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 81(3), 199-205. https://doi.org/10.15417/534
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Clinical Research
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References
1. Kurtz SM, Lau E, Zhao K, et al. Hip and knee revisions: U.S. projections from 2005-2030. Scientific Exhibit SE53. Presented at the 73rd Annual Meeting of the American Academy of Orthopaedic Surgeons, Chicago, IL. March 22-26, 2006.
2. Kurtz SM, Mowat F, Ong K, et al. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 2005;87:1487.
3. Engh Jr CA, Hopper Jr RH, Engh CA. Distal ingrowth components. Clin Orthop 2004;420:135–41.
4. Weeden SH, Paprosky WG. Minimal 11-year followup of extensively porous-coated stems in femoral revision total hip arthroplasty. J Arthroplasty 2002; 17:134.
5. Paprosky WG, Sporer SM. Revision total hip arthroplasty: the limits of fully coated stems. Clin Orthop 2003;417:203.
6. Hamilton WG, Cashen DV, Ho H, Hopper Jr RH, Engh CA. Extensively Porous-Coated Stems for Femoral Revision A Choice for All Seasons. J Arthroplasty 2007; 22 (4) Suppl.
7. McAuley JP, Engh Jr CA. Femoral fixation in the face of considerable bone loss: cylindrical and extensively coated femoral components. Clin Orthop 2004; 429:215.
8. Berry DJ, Harmsen WS, Ilstrup D, Lewallen DG, and Cabanela ME. Survivorship of uncemented proximally porous-coated femoral components. Clin Orthop 1995;319:168.
9. Pellicci PM, Wilson PD, Sledge CB, Salvati EA, Ranawat CS, Poss R. Long-Term Results of Revision Total Hip Replacement A FoLLow-up report. J Bone Joint Surg Am. 67A, 513-516; 1985.
10. Mulroy WF, Harris WH. Revision Total Hip Arthroplasty with Use of So-Called Second-Generation Cementing Techniques for Aseptic Loosening of the Femoral Component. A fifteen year average follow up study. J Bone Joint Surg Am. 78A, 325-330; 1996.
11. Katz, RP, Callaghan JJ, Sullivan PM and Johnston RC. Results of Cemented Femoral Revision Total Hip Arthroplasty Using Improved Cementing Techniques. Clin Orthop 319, 178-183; 1995.
12. Singh SP, Bhalodiya HP. Results of Wagner SL revision stem with impaction bone grafting in revision total hiparthroplasty. Indian J Orthop. 2013 Jul;47(4):357-63.
13. Scanelli JA, Brown TE. Femoral impaction grafting. World J Orthop. 2013 Jan 18;4(1):7-11.
14. Stroet MA, Gardeniers JW, Verdonschot N, Rijnen WH, Slooff TJ, Schreurs BW. Femoral component revision with use of impaction bone-grafting and a cemented polished stem: a concise follow-up, at fifteen to twenty years, of a previous report. J Bone Joint Surg Am. 2012 Dec 5;94(23):e1731-4.
15. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Am. 69B, 45-55; 1987.
16. Chung LH, Wu PK, Chen CF, Chen WM, Chen TH, Liu CL. Extensively Porous-coated Stems for Femoral Revision: Reliable Choice for Stem Revision in Paprosky Femoral Type III Defects. Orthopedics. 2012 Jul 1;35(7):e1017-21.
17. Moreland JR, Bernstein ML. Femoral revision hip arthroplasty with uncemented, porous-coated stems. Clin Orthop 1995, 319:141–150.
18. Krishnamurthy AB, MacDonald SJ, Paprosky WG. 5-to 13- year follow-up study on cementless femoral components in revision surgery. J Arthroplasty 1997, 12:839–847.
19. Moreland JR, Moreno MA. Cementless femoral revision arthroplasty of the hip: Minimum 5 years followup. Clin Orthop 2001; 393: 194-201.
20. Vindver G, Bidolegui F, Di Stéfano C. Osteotomía trocantérea extendida para revisiones femorales: indicaciones, técnica y resultados. Evaluación de 100 pacientes con 116 osteotomías. Rev Asoc Argent Ortop Traumatol 2010, 75: 115-124.
21. Bidolegui F, Pereira S, Lugones A, Pereira H, Vindver G. Revisión acetabular con conservación del componente metálico osteointegrado y cementado de un componente de polietileno. Reporte de una serie de 40 casos. Rev Asoc Argent Ortop Traumatol 2013, 78: 190-198
22. Duncan CP, Masri BA. Fractures of the femur after hip repleacement. Instr Course Lect. 1995;44:293-304
23. Harris WH. Traumatic arthitis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg Am. 1969;51A:737-745
2. Kurtz SM, Mowat F, Ong K, et al. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 2005;87:1487.
3. Engh Jr CA, Hopper Jr RH, Engh CA. Distal ingrowth components. Clin Orthop 2004;420:135–41.
4. Weeden SH, Paprosky WG. Minimal 11-year followup of extensively porous-coated stems in femoral revision total hip arthroplasty. J Arthroplasty 2002; 17:134.
5. Paprosky WG, Sporer SM. Revision total hip arthroplasty: the limits of fully coated stems. Clin Orthop 2003;417:203.
6. Hamilton WG, Cashen DV, Ho H, Hopper Jr RH, Engh CA. Extensively Porous-Coated Stems for Femoral Revision A Choice for All Seasons. J Arthroplasty 2007; 22 (4) Suppl.
7. McAuley JP, Engh Jr CA. Femoral fixation in the face of considerable bone loss: cylindrical and extensively coated femoral components. Clin Orthop 2004; 429:215.
8. Berry DJ, Harmsen WS, Ilstrup D, Lewallen DG, and Cabanela ME. Survivorship of uncemented proximally porous-coated femoral components. Clin Orthop 1995;319:168.
9. Pellicci PM, Wilson PD, Sledge CB, Salvati EA, Ranawat CS, Poss R. Long-Term Results of Revision Total Hip Replacement A FoLLow-up report. J Bone Joint Surg Am. 67A, 513-516; 1985.
10. Mulroy WF, Harris WH. Revision Total Hip Arthroplasty with Use of So-Called Second-Generation Cementing Techniques for Aseptic Loosening of the Femoral Component. A fifteen year average follow up study. J Bone Joint Surg Am. 78A, 325-330; 1996.
11. Katz, RP, Callaghan JJ, Sullivan PM and Johnston RC. Results of Cemented Femoral Revision Total Hip Arthroplasty Using Improved Cementing Techniques. Clin Orthop 319, 178-183; 1995.
12. Singh SP, Bhalodiya HP. Results of Wagner SL revision stem with impaction bone grafting in revision total hiparthroplasty. Indian J Orthop. 2013 Jul;47(4):357-63.
13. Scanelli JA, Brown TE. Femoral impaction grafting. World J Orthop. 2013 Jan 18;4(1):7-11.
14. Stroet MA, Gardeniers JW, Verdonschot N, Rijnen WH, Slooff TJ, Schreurs BW. Femoral component revision with use of impaction bone-grafting and a cemented polished stem: a concise follow-up, at fifteen to twenty years, of a previous report. J Bone Joint Surg Am. 2012 Dec 5;94(23):e1731-4.
15. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Am. 69B, 45-55; 1987.
16. Chung LH, Wu PK, Chen CF, Chen WM, Chen TH, Liu CL. Extensively Porous-coated Stems for Femoral Revision: Reliable Choice for Stem Revision in Paprosky Femoral Type III Defects. Orthopedics. 2012 Jul 1;35(7):e1017-21.
17. Moreland JR, Bernstein ML. Femoral revision hip arthroplasty with uncemented, porous-coated stems. Clin Orthop 1995, 319:141–150.
18. Krishnamurthy AB, MacDonald SJ, Paprosky WG. 5-to 13- year follow-up study on cementless femoral components in revision surgery. J Arthroplasty 1997, 12:839–847.
19. Moreland JR, Moreno MA. Cementless femoral revision arthroplasty of the hip: Minimum 5 years followup. Clin Orthop 2001; 393: 194-201.
20. Vindver G, Bidolegui F, Di Stéfano C. Osteotomía trocantérea extendida para revisiones femorales: indicaciones, técnica y resultados. Evaluación de 100 pacientes con 116 osteotomías. Rev Asoc Argent Ortop Traumatol 2010, 75: 115-124.
21. Bidolegui F, Pereira S, Lugones A, Pereira H, Vindver G. Revisión acetabular con conservación del componente metálico osteointegrado y cementado de un componente de polietileno. Reporte de una serie de 40 casos. Rev Asoc Argent Ortop Traumatol 2013, 78: 190-198
22. Duncan CP, Masri BA. Fractures of the femur after hip repleacement. Instr Course Lect. 1995;44:293-304
23. Harris WH. Traumatic arthitis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg Am. 1969;51A:737-745