A prospective outcomes analysis of femoral component fixation in revision total hip arthroplasty.
A prospective, surgeon-allocated, matched cohort analysis of patient outcomes compared cementless, modular metaphyseal and cemented femoral fixation used for revision total hip arthroplasty. First-time femoral revision operations (with and without acetabular revision) with Paprosky types I and II femoral bone stock were included. This series of 86 patients was matched for age, weight, diagnosis, Charnley class, Demand category, femoral bone stock, and outcome measures. At 8-year average follow-up (range, 4-13 years), there were no significant differences in visual analog pain scores (VAPS), Harris Hip Scores (HSS), and SF-36 Physical Function and Bodily Pain scores. One femoral rerevision (2.3%) occurred in the cementless group, and 2 (4.6%) occurred in the cemented group (P = .557). Five-year survivorship for femoral rerevision was 94% for patients with cementless, modular metaphyseal fixation and 92% for patients with cemented fixation. In this study, cementless, modular metaphyseal fixation and cemented femoral fixation were both successful at intermediate-term follow-up in Paprosky types I and II femoral bone (level of evidence: therapeutic study; level II, prospective comparative study).
Department of Orthopaedic Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts, USA.
Richard
R
Iorio
William L
WL
Healy
Anthony H
AH
Presutti
D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D001843:Bone Cements; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation
D001843:Bone Cements