Minimal 11-year follow-up of extensively porous-coated stems in femoral revision total hip arthroplasty

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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Cementation of a dual-mobility cup into a well-fixed cementless shell in patients with high risk of dislocation undergoing revision total hip arthroplasty

Hip International ◽

10.1177/1120700019873617 ◽

2019 ◽

pp. 112070001987361 ◽

Cited By ~ 3

Author(s):

Jesús Moreta ◽

Iker Uriarte ◽

Xabier Foruria ◽

Ioar Urra ◽

Urko Aguirre ◽

...

Keyword(s):

High Risk ◽

Total Hip Arthroplasty ◽

Aseptic Loosening ◽

Hip Arthroplasty ◽

Recurrent Dislocation ◽

Revision Total Hip Arthroplasty ◽

Dual Mobility ◽

Total Hip ◽

Revision Tha

Background: Cementation of polyethylene liners into well-fixed cementless metal shells has become an option during revision total hip arthroplasty (THA). We report the results of cementing a dual-mobility (DM) component into a stable acetabular shell in high-risk patients undergoing revision THA. Methods: A single-centre series of 10 patients undergoing revision THA with a DM cup cemented into an existing well-fixed shell between 2012 and 2016 were retrospectively reviewed. Failure due to aseptic loosening or instability and implant survival at last follow-up were analysed. The average age was 79.2 years and mean follow-up was 3.5 years. Indications were recurrent hip dislocation in 8 cases and intraoperative instability with moderate abductor insufficiency in 2 cases. In cases with recurrent dislocation, the aetiology of instability was classified by Wera type. Results: At the latest follow-up, Harris Hip Scores had improved from 49.3 preoperatively to 71.3 postoperatively ( p = 0.098). In the 8 patients with recurrent dislocation, 4 cases (50%) had an unclear aetiology (Wera type 6), 2 (25%) abductor deficiency (Wera type 3) and 2 (25%) late polyethylene wear (type 5). Postoperative recurrent dislocation occurred in 1 hip (10%). No cases of intraprosthetic dislocation, aseptic loosening of the previous shell or dissociation at the cement-cup interface were identified. Conclusion: Although the follow-up of this series is short, cementation of a DM cup into a previous well-fixed socket seems to be a viable option to treat and prevent instability after revision THA, without providing constraint at the cement-cup interface.

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Cemented revision total hip arthroplasty using contemporary techniques: A minimum ten year follow-up study

The Journal of Arthroplasty ◽

10.1016/0883-5403(94)90149-x ◽

1994 ◽

Vol 9 (1) ◽

pp. 103

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Revision Total Hip Arthroplasty ◽

Total Hip ◽

Follow Up Study

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Cement Removal from the Femur Using the ROBODOC System in Revision Total Hip Arthroplasty

Advances in Orthopedics ◽

10.1155/2013/347358 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Mitsuyoshi Yamamura ◽

Nobuo Nakamura ◽

Hidenobu Miki ◽

Takashi Nishii ◽

Nobuhiko Sugano

Keyword(s):

Total Hip Arthroplasty ◽

Bone Cement ◽

Hip Arthroplasty ◽

Weight Bearing ◽

Full Weight Bearing ◽

Revision Total Hip Arthroplasty ◽

Total Hip ◽

Revision Tha ◽

Cement Removal

Introduction. The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications. The ROBODOC system has been designed to selectively remove bone cement from the femoral canal, but results have not been reported yet. The purpose of our study was to evaluate the clinical and radiographic results of revision THA using the ROBODOC system for cement removal.Materials and Methods. The subjects comprised 19 patients who underwent revision THA using the ROBODOC system. The minimum duration of follow-up was 76 months (median, 109 months; range, 76–150 months). The extent of remaining bone cement on postoperative radiography, timing of weight bearing, and the complications were evaluated.Results. The mean Merle d’Aubigne and Postel score increased from 10 points preoperatively to 14 points by final follow-up. Bone cement was completely removed in all cases. Full weight bearing was possible within 1 week after surgery in 9 of the 19 cases and within 2 months in all remaining cases. No instances of perforation or fracture of the femur were encountered.Conclusions. Bone cement could be safely removed using the ROBODOC system, and no serious complications occurred. Full weight bearing was achieved early in the postoperative course because of circumferential preservation of the femoral cortex.

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A 2- to 16-Year Clinical Follow-Up of Revision Total Hip Arthroplasty Using a New Acetabular Implant Combined With Impacted Bone Allografts and a Cemented Cup

The Journal of Arthroplasty ◽

10.1016/j.arth.2017.10.006 ◽

2018 ◽

Vol 33 (3) ◽

pp. 815-822 ◽

Cited By ~ 10

Author(s):

Hampus Stigbrand ◽

Oscar Gustafsson ◽

Gösta Ullmark

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Revision Total Hip Arthroplasty ◽

Total Hip ◽

Bone Allografts ◽

Cemented Cup ◽

Acetabular Implant

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A 3- to 18-Year Follow-Up of Revision Total Hip Arthroplasty With Impacted Bone Allografts and Cemented Lubinus SP II Stem. Clinical, Radiographic, and Survivorship Analysis With Comparison to the Literature

The Journal of Arthroplasty ◽

10.1016/j.arth.2017.04.012 ◽

2017 ◽

Vol 32 (9) ◽

pp. 2810-2814 ◽

Cited By ~ 4

Author(s):

Hampus Stigbrand ◽

Gösta Ullmark

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Revision Total Hip Arthroplasty ◽

Survivorship Analysis ◽

Total Hip ◽

Bone Allografts

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Structural and Morselized Allografting Combined with a Cementless Cup for Acetabular Defects in Revision Total Hip Arthroplasty: A 4- to 14-Year Follow-Up

BioMed Research International ◽

10.1155/2018/2364269 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Hou-Tsung Chen ◽

Cheng-Ta Wu ◽

Tsan-Wen Huang ◽

Hsin-Nung Shih ◽

Jun-Wen Wang ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Type Ii ◽

Revision Total Hip Arthroplasty ◽

Total Hip ◽

Press Fit ◽

Cementless Cup ◽

Revision Tha ◽

Acetabular Defects

Using morselized and structural allograft to restore bone stock for massive acetabular bone defect in revision total hip arthroplasty (THA) is an appealing procedure. However, concerns about inability to achieve long-term stability following allograft resorption remained. From 2003 to 2012, 59 hips in 58 patients undergoing revision THA for Paprosky type II or III acetabular defects were retrospectively reviewed. The acetabular defects were managed with deep-frozen morselized and structural allografts, and a press-fit cementless cup along with supplementary screws. Clinical outcomes and radiographic results were analyzed with a mean follow-up of 8.7 years. The clinical successful rate was 100% for hips with Paprosky type II defect, 95.2% for IIIA defect, and 92.8% for IIIB defect. Three hips with type III defect failed at 4, 7, and 9 years, respectively. Harris Hip Score improved significantly from 60.1 preoperatively to 91.3 at the latest follow-up. All hips with good clinical results showed trabecular bridging in the allograft-host bone interface. Deep-frozen structural and morselized allograft in combination with a press-fit cementless cup represented a viable option to reconstruct acetabular defects in revision THA.

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