The Use of a Megaprosthesis in the Management of Stem Loosening after Revision Hip Arthroplasty in a Patient with Extensive Femoral Bone Destruction. Case Study

2021 ◽  
Vol 23 (6) ◽  
pp. 445-450
Author(s):  
Maciej Mądry ◽  
Bartłomiej Kwapisz ◽  
Daniel Kotrych
Keyword(s):  
Female Patient ◽  
Hip Arthroplasty ◽  
Bone Destruction ◽  
Revision Hip Arthroplasty ◽  
Femoral Bone ◽  
Stem Loosening ◽  
Primary Hip Arthroplasty

This paper presents the case of a female patient who underwent eleven revision surgeries after primary hip arthroplasty due to infection and loosening of the stem and acetabulum. We decided that in order to save the limb, it was necessary to use a total femur prosthesis. Three years’ follow-up showed that the patient was satis­fied with the outcome of the surgery.

Treatment of Primary Hip Arthroplasty Complications. Case Study

2018 ◽  
Vol 20 (5) ◽  
pp. 421-430 ◽  
Author(s):  
Paweł Kamiński ◽  
Adam Zawojski ◽  
Jerzy Mirosław Jaworski ◽  
Magdalena Wilk-Frańczuk
Keyword(s):  
Female Patient ◽  
Hip Arthroplasty ◽  
Femoral Fracture ◽  
Preoperative Planning ◽  
Correct Diagnosis ◽  
Periprosthetic Femoral Fracture ◽  
Two Stage ◽  
Appropriate Treatment ◽  
Primary Hip Arthroplasty

Intraoperative periprosthetic femoral fracture during hip arthroplasty is one of the most serious surgical com­plications. Its consequences can be minimized with correct diagnosis and early institution of appropriate treatment. This paper presents the management of a periprosthetic femoral fracture complicated by infection in a 53-year-old female patient. The patient underwent three revision surgeries. The first one consisted in treating the fracture and was complicated by another fracture and infection. This was followed by a two-stage treatment of the infection with a cementless revision stem arthroplasty. Arthroplasty procedures should be preceded by appropriate preoperative planning. In the treatment of peri­pro­sthetic fractures, it is essential to use appropriate implants and adhere to the AO principles of fracture ma­nagement.

scholarly journals Allogenic bone graft for femoral defect augmentation in hip revision arthroplasty: A case series

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Nils Wirries ◽  
Michael Skutek ◽  
Marcus Örgel ◽  
Stefan Budde ◽  
Alexander Derksen ◽  
...  
Keyword(s):  
Bone Loss ◽  
Bone Graft ◽  
Cortical Bone ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Revision Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Femoral Bone ◽  
Allogenic Bone

Cortical bone loss in revision hip arthroplasty requires an adequate stabilization to achieve a durable implant fixation. This case series shall illustrate possible indications for the use of allogenic grafts in revision hip arthroplasty. Twelve patients with femoral bone loss were treated with allografts. In addition to established clinical scores, the radiological follow-ups were analyzed for hints of implants loosening and the osteointegration of the allografts. After a mean follow-up of 3.0 years the mHHS was 61.3 points and the UCLA 3.8. One patient showed a non-progressive radiolucency around the hip implant. The osteointegration of all allogenic grafts happened on time. Up to the last follow-up no revision surgery of the hip implants and the associated femoral bone graft was observed. Allogenic bone grafts present a method for biological stabilization in situations of large femoral cortical bone defects in revision hip arthroplasty.

Extensively Hydroxyapatite-Coated Stems in Revision Hip Arthroplasty: A Radiological Mid-Term follow-up Study

2005 ◽  
Vol 15 (1) ◽  
pp. 38-45
Author(s):  
D. Hernández-Vaquero ◽  
A. Suarez-Vazquez ◽  
M. Cima-Suarez ◽  
M. A. Garcia-Sandoval ◽  
R. Gava
Keyword(s):  
Hip Arthroplasty ◽  
Revision Hip Arthroplasty ◽  
Follow Up Study

The minimalinvasive direct anterior approach in aseptic cup revision hip arthroplasty: a mid-term follow-up

2018 ◽  
Vol 139 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Marc Dominique Horsthemke ◽  
Christoph Koenig ◽  
Georg Gosheger ◽  
Jendrik Hardes ◽  
Steffen Hoell
Keyword(s):  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Revision Hip Arthroplasty ◽  
Cup Revision

scholarly journals Ten-year comparison of two different techniques for femoral bone cavity preparation—broaching versus compaction in patients with cementless total hip arthroplasty

2021 ◽  
Vol 2 (12) ◽  
pp. 1035-1042
Author(s):  
Maciej Okowinski ◽  
Mette Holm Hjorth ◽  
Sebastian Breddam Mosegaard ◽  
Jonathan Hugo Jürgens-Lahnstein ◽  
Stig Storgaard Jakobsen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Bone ◽  
Total Hip ◽  
Stem Subsidence ◽  
Femur Fractures

Aims Femoral bone preparation using compaction technique has been shown to preserve bone and improve implant fixation in animal models. No long-term clinical outcomes are available. There are no significant long-term differences between compaction and broaching techniques for primary total hip arthroplasty (THA) in terms of migration, clinical, and radiological outcomes. Methods A total of 28 patients received one-stage bilateral primary THA with cementless femoral stems (56 hips). They were randomized to compaction on one femur and broaching on the contralateral femur. Overall, 13 patients were lost to the ten-year follow-up leaving 30 hips to be evaluated in terms of stem migration (using radiostereometry), radiological changes, Harris Hip Score, Oxford Hip Score, and complications. Results Over a mean follow-up period of 10.6 years, the mean stem subsidence was similar between groups, with a mean of -1.20 mm (95% confidence interval (CI) -2.28 to -0.12) in the broaching group and a mean of -0.73 mm (95% CI -1.65 to 0.20) in the compaction group (p = 0.07). The long-term migration patterns of all stems were similar. The clinical and radiological outcomes were similar between groups. There were two intraoperative fractures in the compaction group that were fixed with cable wire and healed without complications. No stems were revised. Conclusion Similar stem subsidence and radiological and clinical outcomes were identified after the use of compaction and broaching techniques of the femur at long-term follow-up. Only the compaction group had intraoperative periprosthetic femur fractures, but there were no long-term consequences of these. Cite this article: Bone Jt Open 2021;2(12):1035–1042.

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.

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

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.

Proximal Femoral Reconstruction for Revision Hip Arthroplasty with Severe Bone Loss: A New Technique Using Autologous Bone Graft and a Proximally Loading Femoral Component

1997 ◽  
Vol 7 (1) ◽  
pp. 3-10 ◽  
Author(s):  
J. Alfaro Adrian ◽  
M. Emerton ◽  
D.W. Murray ◽  
P. Mclardy-Smith
Keyword(s):  
Bone Loss ◽  
Bone Graft ◽  
Hip Arthroplasty ◽  
Autologous Bone Graft ◽  
Revision Hip Arthroplasty ◽  
Severe Bone Loss ◽  
Successful Technique ◽  
A New Technique ◽  
Proximal Femoral Reconstruction

We report the results of a new method of reconstructing the femur in 22 patients with severe bone loss having revision hip arthroplasty. The calcar and metaphysis were reconstructed with cortico-cancellous autograft around a new modular hip replacement. The metaphyseal portion of the implant is free to slide on the stem and therefore loads the graft and, we believe, encourages bone graft incorporation. The stem gains cementless fixation distal to the area of bone loss, thus preventing fractures and allowing the areas of bone loss to heal. At the time of review at a mean of 3 years follow-up there had been no revisions (since then there has been one re-revision due to recurrence of infection). The modified D'Aubigné and Postel hip score improved from 7.3 to 15. In 17 patients the graft has incorporated, in 5 it has partially resorbed but the prosthesis remains secure. We conclude that this is a relatively simple and successful technique for overcoming the problem of major femoral bone loss.

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