Conversion of a Long Distally Fixed Uncemented Revision Femoral Stem to a Proximally Fixed Implant following Fatigue Fracture

2011 ◽  
Vol 21 (6) ◽  
pp. 766-769 ◽  
Author(s):  
Peter S. Young ◽  
Rory G. Middleton ◽  
Ian D. Learmonth ◽  
Tahawwar Hasnat A. Minhas
Keyword(s):  
Fatigue Fracture ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Revision Arthroplasty ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Hip Revision ◽  
Clear Cut ◽  
Younger Patient ◽  
Primary Hip Arthroplasty

There has been increasing focus on bone conservation through proximal fixation in primary hip arthroplasty. However, the debate regarding fixation in revision arthroplasty and which factors influence implant choice remains less clear-cut. We report a case involving fatigue fracture of a long, distally well-fixed, uncemented revision stem. This was revised to a proximally fixed implant. This case highlights a number of issues when considering the choice of implant in hip revision surgery and raises the issue of bone conservation in revision surgery. We would suggest that in both primary and revision hip arthroplasty meticulous pre-operative consideration of the choice of implant should be undertaken, especially in the younger patient with higher expectations and functional demands.

scholarly journals Thromboprophylaxis for Hip Revision Arthroplasty: Can We Use the Recommendations for Primary Hip Surgery? A Cohort Study

2019 ◽  
Vol 25 ◽  
pp. 107602961882016 ◽  
Author(s):  
Maria Bautista ◽  
Meilyn Muskus ◽  
Daniela Tafur ◽  
Guillermo Bonilla ◽  
Adolfo Llinás ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Revision Arthroplasty ◽  
Thromboembolic Events ◽  
Bleeding Events ◽  
Hip Revision ◽  
Hip Revision Arthroplasty ◽  
Hip Revision Surgery ◽  
Primary Hip Arthroplasty

The risk of thromboembolic events after hip revision arthroplasty might be higher than in primary hip arthroplasty. However, evidence regarding the use of thromboprophylaxis in revisions is scarce. The purpose of this study is to determine whether thromboprophylaxis recommendations for primary arthroplasty produce similar results in hip revision arthroplasty. This comparative cohort study retrospectively analyzed consecutive patients undergoing primary hip arthroplasty and hip revision surgery between March 2004 and December 2015, who received thromboprophylaxis according to local clinical practice guidelines for primary hip arthroplasty. The prevalence of deep vein thrombosis and pulmonary embolism and the presence of major bleeding events were assessed during hospitalization and at 3 months after discharge and compared between groups. The overall prevalence of thromboembolic events in the hip revision surgery cohort and in the primary hip cohort was 1.62% and 1.35%, respectively ( P = .801). The 38.4% of hip revision patients and 20.3% of primary hip patients presented major bleeding events. Thromboembolic disease outcomes with the use of a standardized thromboprophylaxis regimen were similar in both cohorts, regardless of the high variability of hip revision surgery and the increased risk of complications. Implementation of this regimen is recommended in patients requiring joint replacement revision surgery.

scholarly journals Revision Hip Arthroplasty: Epidemiology, Causes, Risk Factors (foreign literature review)

2015 ◽  
pp. 83-89 ◽  
Author(s):  
A. V. Kaminskiy ◽  
L. O. Marchenkova ◽  
A. V. Pozdnyakov
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Hip Arthroplasty ◽  
Significant Risk ◽  
Revision Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Foreign Literature ◽  
Primary Hip Arthroplasty

Publications related to revision hip arthroplasty were analyzed. Data of National Registers from different countries were presented, problems of epidemiology and prognostication of need in revision arthroplasty were highlighted, the causes (demographic, clinical, surgical, rehabilitation) and the most significant risk factors that conditioned the failure of primary hip arthroplasty were described.

scholarly journals Medium Term Outcome of Lancaster Cortical Window Technique For Extraction of Femoral Stem in Revision Hip Arthroplasty

2021 ◽  
Author(s):  
Amit Singh ◽  
Sunirmal Mukherjee ◽  
Kuntal Patel ◽  
Deepak Herlekar ◽  
Srikant Gandavaram ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Medium Term ◽  
Term Outcome ◽  
Window Technique ◽  
Femoral Stems ◽  
The Mean

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster Cortical Window technique which can be used for removal of cemented or uncemented femoral stems. Methodology The study was conducted at a specialist centre in the North-West of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using Lancaster Cortical Window technique for removal of femoral implant during a revision hip arthroplasty. Patient’s electronic notes and the radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using Novel Lancaster Window technique. The mean age of the all the patients was 81.5 years and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular component. Rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow up. Conclusion We believe Lancaster cortical window technique can be safely used for removal of cemented stems during revision hip arthroplasty without the need for expensive equipment’s.

scholarly journals The short-term outcome of hip revision arthroplasty with Trabecular Metal™ components and augments

2020 ◽  
Vol 19 (3) ◽  
Author(s):  
L Noconjo ◽  
MB Nortje
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Trabecular Metal ◽  
Short Term ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Hip Revision ◽  
Total Hip

ABSTRACT BACKGROUND: Highly porous Trabecular Metal™ acetabular components are increasingly being used in revision hip arthroplasty as they facilitate ingrowth, provide a useful mechanism to deal with bone loss and may decrease the risk of infection. The purpose of this audit was to describe: 1) the total number of hip arthroplasty surgeries over Ave years, the ratio of revision to primary hip arthroplasty and indications for revision; 2) the short-term outcomes of revision hip arthroplasty with Trabecular Metal™ components and augments METHODS: A retrospective folder and radiograph review of all patients who had revision total hip arthroplasty (THA) at a tertiary level hospital from February 2012 to February 2017 was done RESULTS: There were 979 THAs performed over the period - 863 (87%) primary THAs, and 116 (12%) hip revision cases performed in 107 patients. Of the 116 (107 patients) hip revisions, there were seven (6%) re-revisions in Ave patients. The indications for revision were aseptic loosening 67 (59%), septic loosening 11 (10%), liner wear 18 (16%), periprosthetic fracture Ave (4%), other 15 (13%). Trabecular Metal™ was used for revision in 16 hips (14 patients), which is 14% of the total 116 revisions. There were ten females and four males with an average age of 61 years. The average duration of follow-up in this group was 18.5 months (1.5-39.2). In these 16 Trabecular Metal™ hips, there were three (19%) early failures of fixation due to technical errors CONCLUSION: In our institution, 12% of the arthroplasty is revision surgery. The indications for revision are similar to published literature. Trabecular Metal™ revisions had a 19% early failure rate due to technical error Level of evidence: Level 4 Keywords: Trabecular Metal™, augments, total hip arthroplasty, revision hip arthroplasty

scholarly journals Medium term outcome of Lancaster cortical window technique for extraction of femoral stem in revision hip arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Amit Singh ◽  
Sunirmal Mukherjee ◽  
Kuntal Patel ◽  
Deepak Herlekar ◽  
Srikant Gandavaram ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Medium Term ◽  
Term Outcome ◽  
Window Technique ◽  
Femoral Stems ◽  
The Mean

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in the speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster cortical window technique which can be used for the removal of cemented or uncemented femoral stems. Methods The study was conducted at a specialist centre in the north-west of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using the Lancaster cortical window technique for removal of the femoral implant during a revision hip arthroplasty. Patient’s electronic notes and radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using the novel Lancaster window technique. The mean age of all the patients was 81.5 years, and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular components. The rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow-up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow-up. Conclusion We believe Lancaster cortical window technique can be safely used for the removal of cemented stems during revision hip arthroplasty without the need for expensive equipment.

scholarly journals Revision Hip Arthroplasty: Epidemiology, Causes, Risk Factors (foreign literature review)

2015 ◽  
Vol 22 (2) ◽  
pp. 83-89
Author(s):  
A. V Kaminskiy ◽  
L. O Marchenkova ◽  
A. V Pozdnyakov
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Hip Arthroplasty ◽  
Significant Risk ◽  
Revision Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Foreign Literature ◽  
Primary Hip Arthroplasty

Publications related to revision hip arthroplasty were analyzed. Data of National Registers from different countries were presented, problems of epidemiology and prognostication of need in revision arthroplasty were highlighted, the causes (demographic, clinical, surgical, rehabilitation) and the most significant risk factors that conditioned the failure of primary hip arthroplasty were described.

scholarly journals Experience in use of Wagner SL Revision Stem for Revision Hip Arthroplasty

2014 ◽  
pp. 40-45
Author(s):  
G. M. Kavalerskiy ◽  
V. Yu. Murylyov ◽  
Ya. A. Rukin ◽  
M. Yu. Kholodaev ◽  
P. M. Elizarov
Keyword(s):  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Femoral Bone ◽  
Defect Type ◽  
Hip Implant ◽  
Femoral Defect ◽  
Revision Stem

Experience in revision hip arthroplasty with change of femoral stem was analyzed for 165 patients. In 107 operations (64.8%) Wagner SL Revision Stems were used, in the rest of cases - femoral components of other manufacturers. Distribution of patients by femoral defect type by Paprovsky was the following: I type - 27 patients, II type - 75, IIIA type - 59, IIIB and IV type - 4 patients. Good results at use of Wagner SL Revision Stems and stems of other manufacturers were comparable and made up 87.9 and 86.2%, respectively. Achieved data enabled to make conclusion that Wagner SL Revision Stem use is reasonable for patients with hip implant instability in I-IIIA femoral bone deficit, as they are cheaper than the modular revision stems and their design prevents the wear in the area of modular junction.

Treatment of Femoral Fractures Associated with Stem Loosening following Total Hip Arthroplasty

1998 ◽  
Vol 8 (3) ◽  
pp. 138-144 ◽  
Author(s):  
B. Erdemli ◽  
I. Gurkan ◽  
B. Guzel ◽  
I. Cetin
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Prosthesis ◽  
Femoral Fractures ◽  
Early Mobilization ◽  
Revision Operation ◽  
Hip Revision ◽  
Total Hip ◽  
Primary Hip Arthroplasty ◽  
Fractures Of The Femur

We report the results of Kent hip revision arthroplasties performed in 5 patients with fractures of the femur associated with femoral loosening following total hip arthroplasty. The fractures occurred at an average of 40.4 months following the primary hip arthroplasty. The system of Merle D'Aubigné and Postel, as modified by Charnley, was used for the clinical evaluation. One to four years (mean, 2.6 years) after the revision operation, the clinical and radiographic results were satisfactory. With the help of the transfixion screws the Kent Hip prosthesis provides stable fixation and facilitates early mobilization, with its attendant advantages.

Results of Revision Hip Arthroplasty using Cemented Femoral Stem

2007 ◽  
Vol 19 (4) ◽  
pp. 472 ◽  
Author(s):  
Joong Myung Lee ◽  
Jae Young Roh ◽  
Young Soo Park
Keyword(s):  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty

Fracture of the Femoral Stem as a Rare Complication of Total Hip Arthroplasty. Cases Report

2018 ◽  
Vol 20 (4) ◽  
pp. 313-326
Author(s):  
Marek Drobniewski ◽  
Andrzej Borowski ◽  
Magdalena Krasińska ◽  
Piotr Kozłowski ◽  
Marek Synder
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Rare Complication ◽  
Femoral Stem ◽  
Femoral Shaft ◽  
Late Complications ◽  
Transfemoral Approach ◽  
Total Hip ◽  
Primary Hip Arthroplasty ◽  
Stem Fracture

The aim of this paper is to present the femoral stem fracture as a rare complication of total hip arthroplasty and describe further management in such cases. We present 5 cases of stem fracture in the Mittelmeier prosthe­sis which occurred from 8 to 29 years after the primary procedure. In three cases, the primary hip arthroplasty was performed due to dysplastic coxarthrosis. The remaining two patients had idiopathic and post-traumatic coxarthrosis. The four female patients underwent revision hip arthroplasty with stem replacement. One patient refused surgical treatment and has been followed up at the outpatient clinic. Annual clinical and radiological examination is an approved method for detecting late complications Hip arthroplasty should be performed at specialised centres where relevant prostheses and instruments are used. A transfemoral approach and the use of revision stems anchored in the femoral shaft is a method of choice for revision procedures performed due to stem fractures.

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