title: Techniques for removal of the stem: transfemoral or intramedullary?
abstract: 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.
authors.affiliation: Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna.
authors.forename: A
authors.initials: A
authors.lastname: Toni
authors.forename: A
authors.initials: A
authors.lastname: Sudanese
authors.forename: M
authors.initials: M
authors.lastname: Tabarroni
authors.forename: F
authors.initials: F
authors.lastname: Calista
authors.forename: F A
authors.initials: FA
authors.lastname: Zappoli
authors.forename: L
authors.initials: L
authors.lastname: Brizio
authors.forename: A
authors.initials: A
authors.lastname: Giunti
mesh_terms: D001853:Bone Marrow; D005269:Femur; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000379:methods*; D006801:Humans; D012086:Reoperation