Clinical, functional and radiographic outcomes after revision total hip arthroplasty with tapered fluted modular or non-modular stems: a systematic review

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.

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Mid-term results of revision total hip arthroplasty with an uncemented modular femoral component

Hip International ◽

10.5301/hipint.5000522 ◽

2017 ◽

Vol 28 (1) ◽

pp. 84-89 ◽

Cited By ~ 7

Author(s):

Bertram Rieger ◽

Thomas Ilchmann ◽

Lilianna Bolliger ◽

Karl K. Stoffel ◽

Lukas Zwicky ◽

...

Keyword(s):

Retrospective Study ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Fractures ◽

Revision Total Hip Arthroplasty ◽

Term Outcome ◽

Term Survival ◽

Total Hip ◽

Radiographic Outcomes

Introduction: During revision total hip arthroplasty (THA), the surgeon commonly faces deficient proximal femoral bone. In this situation, distal fixation of the prosthesis is required. The aim of the current retrospective study is to assess the clinical and radiographic mid-term outcome of revision total hip arthroplasty using a modular uncemented, tapered, grit-blasted, distal straight stem system. Methods: This retrospective study included 70 femoral revisions that were performed in 67 patients using the device of interest. All patients were operated on via an extended trochanteric osteotomy. 60 revisions were performed as 1-stage (12 infected) and 10 as 2-stage (all infected) revisions. At 3 months postoperatively and at final follow-up, patients were assessed radiographically for the presence of osteolysis and for distal integration. Results: The mean follow-up time was 4.3 (2.0-7.6) years. 4 patients had a removal of at least 1 prosthetic component. Stem survival for any reason was 92% after 5 years (95% confidence interval [CI], 83%-100%). With aseptic loosening of the stem as the endpoint of interest, survival after 5 years was 96% (95% CI, 88%-100%). A postoperative subsidence rate of 14.7% was found. No perioperative femoral fractures were found in the current patient series. Conclusions: This study showed excellent mid-term survival and good clinical and radiographic outcomes in patients who had undergone revision THA with a modular uncemented, tapered, straight design.

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Long-Term Survival of the Acetabular Component After Total Hip Arthroplasty with Cement in Patients with Developmental Dysplasia of the Hip

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.d.02689 ◽

2006 ◽

Vol 88 (1) ◽

pp. 71 ◽

Cited By ~ 19

Author(s):

Aslam Chougle

Keyword(s):

Total Hip Arthroplasty ◽

Acetabular Component ◽

Hip Arthroplasty ◽

Developmental Dysplasia ◽

Term Survival ◽

Long Term Survival ◽

Total Hip ◽

Dysplasia Of The Hip

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Mid- to long-term outcomes of cementless modular, fluted, tapered stem for massive femoral bone loss in revision total hip arthroplasty

10.21203/rs.3.rs-37004/v1 ◽

2020 ◽

Author(s):

Kai Zheng ◽

Ning Li ◽

Weicheng Zhang ◽

Jun Zhou ◽

Yaozeng Xu ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Bone Loss ◽

Hip Arthroplasty ◽

Long Term Results ◽

Revision Total Hip Arthroplasty ◽

Femoral Bone ◽

Total Hip ◽

Tapered Stem

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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