Techniques for removal of the stem: transfemoral or intramedullary?
Since 1981 a total of 76 reimplantations of the prosthetic stem have been performed, substituting 52 cemented stems and 24 cementless ones. Only 7 patients (9%) required transcortical access, 3 of these stems (43%) were not osteointegrated, while of the 69 reimplantations performed by intramedullary approach, only 4% of the stems did not achieve skeletal stabilization. A total of 43% of the stems reimplanted using an intramedullary approach were short (12-13 cm). The advantages of intramedullary access may be summarized by saying that diaphyseal cortical bone is saved; in the use of short prosthetic models. The transcortical technique is limited to a minority of patients, particularly to cases where stems that show osteointegration and are cementless are removed.
Toni
A
A
Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna.
Sudanese
A
A
Tabarroni
M
M
Calista
F
F
Zappoli
F A
FA
Brizio
L
L
Giunti
A
A
D001853:Bone Marrow; D005269:Femur; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000379:methods*; D006801:Humans; D012086:Reoperation