Long-term results of Zweymüller SLL femoral stem in revision hip arthroplasty for stage II and IIIA femoral bone defect: a 9–15-year follow-up study

Abstract Background: Revision total hip arthroplasty is frequently accompanied by bone loss. The purpose of this study is to evaluate mid- to long-term results of revision total hip arthroplasty for massive femoral bone loss using cementless modular, fluted, tapered stems.Methods: During the period of 2007 to 2015 at a single hospital, 34 hips (33 patients) underwent primary revision surgery with cementless modular, fluted, tapered stems due to massive bone loss, and patients with prosthetic joint infection (PJI) or tumours were excluded. The hips were revised with the LINK MP (Waldemar Link, Hamburg, Germany) prosthesis. Bone loss was categorized by the Paprosky classification for prosthesis loosening and Vancouver classification for peri-prosthetic fracture. All revision bearing surfaces were ceramic-on-ceramic (CoC). Clinical outcomes, radiographic outcomes and survivorship were evaluated.Results: The mean follow-up was 9.1±2.5 years (range, 5-13 years). The Harris hip score was 43.6±11.5 preoperatively and maintained at 86.5±6.6 at the time of latest follow-up (p<0. 05). The X-ray showed bone ingrowth fixation in 30 hips (88%), fibrous stable fixation in 3 hips (9%) and instability in 1 hip (3%). The average stem subsidence was 3.9±2.2 mm (range, 1 to 10 mm). The survivorship of prostheses with re-revision for any reason was 95% (95% CI, 12.0 to 13.0) at the 10-year follow-up. Three (9%) re-revisions were needed, including 1 for aseptic loosening, 1 for dislocation and 1 for infection.Conclusions: The mid- to long-term results of revision total hip arthroplasty with the cementless modular, fluted, tapered stem (LINK MP stem) are encouraging for massive femoral bone loss.

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Revision Hip Arthroplasty with an Extensively Porous-coated Stem - Excellent Long-term Results Also in Severe Femoral Bone Stock Loss

Hip International ◽

10.5301/hipint.5000032 ◽

2013 ◽

Vol 23 (4) ◽

pp. 352-358 ◽

Cited By ~ 23

Author(s):

Per B. Thomsen ◽

Niels J.F. Jensen ◽

Jens Kampmann ◽

Torben Bæk Hansen

Keyword(s):

Hip Arthroplasty ◽

Revision Hip Arthroplasty ◽

Long Term Results ◽

Bone Stock ◽

Femoral Bone

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Clinical outcomes and survival rate of cementless modular distal fixation femoral stem for revision hip arthroplasty: A minimum 6-year follow-up

Journal of Orthopaedic Surgery ◽

10.1177/2309499018812241 ◽

2018 ◽

Vol 26 (3) ◽

pp. 230949901881224 ◽

Cited By ~ 1

Author(s):

Joon Soon Kang ◽

Yeop Na ◽

Bong Seong Ko ◽

Yoon Sang Jeon

Keyword(s):

Survival Rate ◽

Hip Arthroplasty ◽

Periprosthetic Fracture ◽

Femoral Stem ◽

Revision Hip Arthroplasty ◽

Harris Hip Score ◽

The Mean ◽

Distal Fixation

Purpose: Revision hip arthroplasty is a very challenging procedure. Use of a modular distal fixation stem is one of the available options for revision arthroplasty in patients with proximal femoral bone deficiency. The purpose of this study was to evaluate mid- to long-term outcomes of cementless modular distal fixation femoral stem implantation in revision hip surgery. Methods: Clinical and radiological findings, complications, and stem survival rate were analyzed for 46 patients (48 hips) who underwent revision hip arthroplasty using a cementless modular distal fixation femoral stem. The mean patient age was 58.8 years (range 31–82 years) and the mean follow-up period was 95 months (72–122 months). The preoperative diagnoses were aseptic loosening (36 hips), infection (4 hips), ceramic fracture (4 hips), and femoral periprosthetic fracture (4 hips). Results: The mean Harris hip score improved from 56.6 preoperatively to 88.2 postoperatively at the last follow-up. All hips showed stable osteointegration and firm fixation. Complications involved four hips (8.3%); there was one case each of periprosthetic fracture, delayed union of osteotomy site, femoral perforation, and infection. One stem re-revision was performed for deep infection of the femoral side. The Kaplan–Meier survival rate was 97.6% at the final follow-up. Conclusion: Revision hip arthroplasty using a cementless modular distal fixation femoral stem showed satisfactory initial firm fixation and mid- to long-term survival rate. Complications can be minimized by careful surgical planning and meticulous procedure.

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Management of severe femoral bone defect in revision total hip arthroplasty-A 236 hip, 6-14-year follow-up study

Journal of Huazhong University of Science and Technology [Medical Sciences] ◽

10.1007/s11596-013-1166-z ◽

2013 ◽

Vol 33 (4) ◽

pp. 606-610 ◽

Cited By ~ 3

Author(s):

Guo-qiang Zhang ◽

Yan Wang ◽

Ji-ying Chen ◽

Yong-gang Zhou ◽

Xiu-tang Cao ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Bone Defect ◽

Hip Arthroplasty ◽

Revision Total Hip Arthroplasty ◽

Femoral Bone ◽

Total Hip ◽

Follow Up Study

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Follow-up Study of Long-term Results over 14 years of Charnley Type Total Hip Arthroplasty.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.50.908 ◽

2001 ◽

Vol 50 (3) ◽

pp. 908-913

Author(s):

Yoshiyasu Taniguchi ◽

Shinya Maki ◽

Yujiro Hamasato ◽

Makoto Nakamura ◽

Naoya Kawabata ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Long Term Results ◽

Total Hip ◽

Follow Up Study

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Long Term Results With the Interlocking Uncemented Long Stem in Revision Hip Arthroplasty: A Mean 15-Year Follow-Up

The Journal of Arthroplasty ◽

10.1016/j.arth.2014.12.023 ◽

2015 ◽

Vol 30 (5) ◽

pp. 835-839 ◽

Cited By ~ 2

Author(s):

Tomomi Kamada ◽

Hiroshi Imai ◽

Naohiko Mashima ◽

Jun Takeba ◽

Hideo Okumura ◽

...

Keyword(s):

Hip Arthroplasty ◽

Revision Hip Arthroplasty ◽

Long Term Results ◽

Long Stem

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Long-Term Results of Hip Arthroplasty Using Extensive Porous-Coated Stem—A Minimum Follow-Up of 15 Years

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459319892787 ◽

2019 ◽

Vol 10 ◽

pp. 215145931989278

Author(s):

Myung Hoon Park ◽

Yung Hun Youn ◽

Joon Soon Kang ◽

Kyoung Ho Moon

Keyword(s):

Heterotopic Ossification ◽

Hip Arthroplasty ◽

Stress Shielding ◽

Femoral Stem ◽

Long Term Results ◽

Harris Hip Score ◽

Radiographic Findings ◽

Femoral Stems

Introduction: We report the clinical and radiographic results of hip arthroplasty using extensive porous-coated stems over 15 years in Korea. Methods: This retrospective study included 210 patients (268 hips) who underwent total hip arthroplasties (232 hips) and bipolar hemiarthroplasties (36 hips) between June 1996 and December 2002 for avascular necrosis of the femoral head, hip fracture, or osteoarthritis, after excluding those who died or were lost to follow-up. One senior author (K.H.M.) evaluated Harris Hip Score (HHS); limping gait; and leg length discrepancy, and 3 independent reviewers assessed the radiographic findings, including the level of stress shielding, Dorr classification, subsidence and loosening of femoral stem, heterotopic ossification (Brooker classification), osteolysis of acetabulum, wear rate of the polyethylene liner, component loosening, and revision rate. Results: The mean follow-up duration was 16.9 years and average age at operation was 50.9 years. The HHS improved at the last follow-up. Stress shielding was grade 1 in 185 hips, grade 2 in 35 hips, grade 3 in 37 hips, and grade 4 in 11 hips. Femoral stem subsidence was <3 mm in 4 hips and >3 mm in 6 hips. Femoral stems with stable bony ingrowth were observed in 258 hips, fibrous stable femoral stems in 4 hips, and unstable femoral stems in 6 hips. Heterotopic ossification was class 1 in12 and class 2 in 4 hips. Revision surgery was performed for periprosthetic osteolysis of cup (45 hips), recurrent dislocation (1), unstable femoral stem (1), and infection (1). The Kaplan-Meier survivorship at the 15-year follow-up was 86.2%. The survivorship of femoral stem at 15 years was 99.3%, and if including impending revision due to unstable femoral stem was 97.1%. Disscussion: This study has all the limitations inherent with a retrospective design. However, a large number of patients in this cohort operated on by a single surgeon and a long-term follow-up are some of the potential advantages of the current study. Conclusions: At the 15-year follow-up, extensive porous-coated stem showed relatively good survivorship even in geriatric patients (Dorr type C).

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