Evaluation of Clinical Outcome Using Cementless Middle-length Femoral Stem (180 mm) in Revision Hip Arthroplasty Practicing on Taiwanese Patients
Background: In twenty-first century, the number of primary total hip still increases annually, thus, the amount of revision total hip arthroplasty is still climbing as well. Many different revision stems are available nowadays which provides surgeons more options performing revision surgeries. Howev...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-04-01
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| Series: | Formosan Journal of Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/FJMD.FJMD_335 |
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| Summary: | Background:
In twenty-first century, the number of primary total hip still increases annually, thus, the amount of revision total hip arthroplasty is still climbing as well. Many different revision stems are available nowadays which provides surgeons more options performing revision surgeries. However, complications such as intra-operation fracture, stem loosening and dislocation are still challenges.
Objectives:
We report a case series using this 180 mm straight, fully coated Titanium Plasma Spray cylindrical stem in revision surgeries for Asians and both clinical and radiological results were analyzed.
Materials and Methods:
This is a retrospective case series study of 182 patients in single institute from 2007 to 2017. Patient information and indications for revision surgery were collected from our database and analyzed. All patients were followed-up postoperatively at 6, 12, 24 weeks, one year, then annually afterward. Clinical assessments include walking gait, leg length, wound appearance, neurological status and the difference between pre-op and post-op Merle d’Aubigne score. Radiologic outcome was evaluated by subsidence rate of post operation X-ray during regular follow-up. SPSS software (Version 22.0) was used for statistical analysis.
Results:
There were 145 revision hips that were retrospectively reviewed with a minimum follow-up period of 5 years. Five patients experienced hip dislocation, and all resolved by closed reduction. Seven patients developed recurrent or acute PJI and required further interventions. Two patients experienced intra-operative fracture. The Kaplan–Meier survivorship was 99.3%(144/145) at the last follow-up, and there was no necessity of re-revisions of femoral component. The mean d’Aubigne scores improved from 8.23 (range: 6–11) pre-operatively to 15.57 (range: 12– 18) at last follow-up (P<0.05).
Conclusions:
For Asian patient with shorter stature and bowed femur, this 180 mm cementless middle length femoral stem is a viable implant option which might significantly decreased the chance of intra-operation fracture afterward. |
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| ISSN: | 2210-7940 2210-7959 |