Management of bone loss in revision total hip arthroplasty using custom cementless femoral components.
Forty-seven consecutive revision total hip arthroplasties were performed using porous ingrowth custom-made prostheses designed from plain radiographs and computed tomography scans. At an average follow-up period of 30 months (range, 2-4 years), one revision has been required for loosening. The average Harris pain score was 39 and the average total score was 84 at the last follow-up evaluation. Complications included nine cases (19%) with intraoperatively detected fractures of the proximal femur treated with cerclage wires and seven cases (15%) with subsidence greater than 3 mm. There were no postoperative infections and only two dislocations. At the time of surgery local particulate bone graft was used in all cases. Thirty-four percent required structural graft to restore bone stock; no case required grafting for prosthesis stability. Management of bone loss in total hip arthroplasty using a custom cementless prosthesis appears to provide an attractive alternative to massive bone grafting.
Bargar
W L
WL
Department of Orthopaedic Surgery, Sutter General Hospital, Sacramento, California.
Murzic
W J
WJ
Taylor
J K
JK
Newman
M A
MA
Paul
H A
HA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D016025:Bone Transplantation; D002484:Cementation; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation