Revision Total Hip Arthroplasty With a Monoblock Splined Tapered Grit-Blasted Titanium Stem

被引:20
|
作者
Hellman, Michael D. [1 ]
Kearns, Sean M. [1 ]
Bohl, Daniel D. [1 ]
Haughom, Bryan D. [1 ]
Levine, Brett R. [1 ]
机构
[1] Rush Univ, Med Ctr, Dept Orthopaed Surg, 1611 W Harrison St,Suite 200, Chicago, IL 60612 USA
来源
JOURNAL OF ARTHROPLASTY | 2017年 / 32卷 / 12期
关键词
Wagner-SL stem; revision total hip arthroplasty; femoral component; nonmodular stem; monoblock stem; proximal femoral bone loss; FEMORAL BONE LOSS; UNITED-STATES; REPLACEMENT; DISLOCATION; PROSTHESIS; FRACTURES; FIXATION; FAILURE; JOINT; TERM;
D O I
10.1016/j.arth.2017.06.045
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: In revision total hip arthroplasty (THA), proximal femoral bone loss creates a challenge of achieving adequate stem fixation. The purpose of this study was to examine the outcomes of a monoblock, splined, tapered femoral stem in revision THA. Methods: Outcomes of revision THA using a nonmodular, splined, tapered femoral stem from a single surgeon were reviewed. With a minimum of 2-year follow-up, there were 68 cases (67 patients). Paprosky classification was 3A or greater in 85% of the cases. Preoperative and postoperative Harris Hip Scores (HHS), radiographic subsidence and osseointegration, limb length discrepancy, complications, and reoperations were analyzed. Results: The Harris Hip Score improved from 37.4 +/- SD 19.4 preoperatively to 64.6 +/- SD 21.8 at final follow-up (P < .001). There were 16 revision procedures-8 for septic indications and 8 for aseptic indications. Subsidence occurred at a rate of 3.0% and dislocation at 7.4%. Limb length discrepancy of more than 1 cm after revision was noted in 13.6% of patients. Bone ingrowth was observed in all but 4 patients (94.1%). At 4-year follow-up, Kaplan-Meier estimated survival was 72.9% (95% confidence interval [CI] 57.0-83.8) for all causes of revision, 86.6% (95% CI 72.0-93.9) for all aseptic revision, and 95.5% (95% CI 86.8-98.5) for aseptic femoral revision. Conclusion: Although complications were significant, revision for femoral aseptic loosening occurred in only 3 patients. Given the ability of this monoblock splined tapered stem to adequately provide fixation during complex revision THA, it remains a viable option in the setting of substantial femoral bone defects. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:3698 / 3703
页数:6
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