Mid-term outcomes of titanium modular neck femoral stems in revision total hip arthroplasty.
Revision total hip arthroplasty (revision THA)
clinical and radiographic outcome
implant survival
modular neck
modular stem
Journal
Annals of translational medicine
ISSN: 2305-5839
Titre abrégé: Ann Transl Med
Pays: China
ID NLM: 101617978
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
entrez:
26
4
2019
pubmed:
26
4
2019
medline:
26
4
2019
Statut:
ppublish
Résumé
Modular stems have been widely studied as they allow intraoperative adjustments (offset, anteversion, limb length) to better restore hip biomechanics. Many authors reported outcomes of revision total hip arthroplasty (THA) using modular stems with metaphyseal-diaphyseal junctions, however, little is known about modular neck femoral stems (MNFS) with metaphyseal-epiphyseal junctions. We therefore aimed to report outcomes and implant survival of a MNFS in a consecutive series of revision THA at a minimum follow-up of 5 years. We reviewed a consecutive series of 28 revision THAs performed between February 2010 and March 2012 using an uncemented MNFS. The final study cohort included 25 patients living with their original components, at a mean follow-up of 68.4±7.4 months and aged 67.7±11.6 years at index operation. The Harris Hip Score (HHS) improved from 39.1±19.2 pre-operatively to 78.1±18.3 post-operatively, and the Postel Merle d'Aubigné score (PMA) improved from 9.8±3.0 pre-operatively to 14.8±2.8 post-operatively. The postoperative limb length discrepancy (LLD) was >10 mm in 18% of the hips. There were no significant differences of femoral offset and neck shaft angle (NSA) between operated and contralateral hips. Two hips (8.0%) showed new periprosthetic radiolucent lines. Periprosthetic fractures (PPF) occurred in 3 hips (12%). No subluxations, dislocations or implant breakages were reported. One revision (3.6%) was performed with retrieval of the revision stem for infection. The Kaplan-Meier (KM) survival at 5 years, using stem revision as endpoint, was 96.0%. The Optimal
Sections du résumé
BACKGROUND
BACKGROUND
Modular stems have been widely studied as they allow intraoperative adjustments (offset, anteversion, limb length) to better restore hip biomechanics. Many authors reported outcomes of revision total hip arthroplasty (THA) using modular stems with metaphyseal-diaphyseal junctions, however, little is known about modular neck femoral stems (MNFS) with metaphyseal-epiphyseal junctions. We therefore aimed to report outcomes and implant survival of a MNFS in a consecutive series of revision THA at a minimum follow-up of 5 years.
METHODS
METHODS
We reviewed a consecutive series of 28 revision THAs performed between February 2010 and March 2012 using an uncemented MNFS. The final study cohort included 25 patients living with their original components, at a mean follow-up of 68.4±7.4 months and aged 67.7±11.6 years at index operation.
RESULTS
RESULTS
The Harris Hip Score (HHS) improved from 39.1±19.2 pre-operatively to 78.1±18.3 post-operatively, and the Postel Merle d'Aubigné score (PMA) improved from 9.8±3.0 pre-operatively to 14.8±2.8 post-operatively. The postoperative limb length discrepancy (LLD) was >10 mm in 18% of the hips. There were no significant differences of femoral offset and neck shaft angle (NSA) between operated and contralateral hips. Two hips (8.0%) showed new periprosthetic radiolucent lines. Periprosthetic fractures (PPF) occurred in 3 hips (12%). No subluxations, dislocations or implant breakages were reported. One revision (3.6%) was performed with retrieval of the revision stem for infection. The Kaplan-Meier (KM) survival at 5 years, using stem revision as endpoint, was 96.0%.
CONCLUSIONS
CONCLUSIONS
The Optimal
Identifiants
pubmed: 31019942
doi: 10.21037/atm.2019.01.34
pii: atm-07-05-92
pmc: PMC6462653
doi:
Types de publication
Journal Article
Langues
eng
Pagination
92Déclaration de conflit d'intérêts
Conflicts of Interest: Dr. Ouanezar received fees for consulting from Amplitude SAS during the conduct of the study; Dr. Pibarot received royalties from Amplitude SAS; Dr. Piton is a consultant for Amplitude SAS. The other authors have no conflicts of interest to declare.
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