Major femoral bone loss in revision total hip arthroplasty treated with tapered, porous-coated stems.
Clinical results of revision total hip arthroplasty using fully porous-coated tapered titanium stems to treat severe proximal femoral bone loss were evaluated in a retrospective review of 39 patients (45 hips). The bone was reinforced with cables in 39 hips, and in 14 hips strut allografts were added. Fixation was successful in 44 hips, and one hip required revision to treat undetected fracture and migration of the stem. All the others had radiographic evidence of bone attachment. Neither bone atrophy nor reconstitution was noted. Three patients (3 hips) had mild thigh pain, but the others had no pain related to the femoral component. Eight hips dislocated; one resolved and seven had recurrent dislocation that was treated with a constrained acetabular component, capsulorrhaphy, or liner reorientation. Ten patients (12 hips) used a walker and 10 patients (12 hips) used a cane at the last postoperative visit. Whereas fixation was successful with this surgical technique, complications related to deficiency of the soft tissue structures were common.
Whiteside
Leo A
LA
Missouri Bone and Joint Research Foundation, Missouri Bone and Joint Center, 12634 Olive Blvd., St. Louis, MO 63141, USA. whiteside@whitesidebio.com
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D001862:Bone Resorption / Q000175:diagnosis / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D015331:Cohort Studies; D005260:Female; D005270:Femur Head / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible