title: Influence of technique with distally fixed modular stems in revision total hip arthroplasty.
abstract: Distally fixed modular implants have seen a recent increase in use, to manage proximal femoral bone loss often encountered during revision total hip arthroplasty (THA). Forty-three distally fixed modular stems implanted at our institution between 1999 and 2006 were clinically and radiographically reviewed. These patients had either a minimum 2-year follow-up (average, 2.4 years; range, 2-5.6 years) or failure (ie, explant or rerevision required). Eleven stems subsided, and 4 were rerevised (n = 4), for a rate of 9.3%. All revised stems were radiographically undersized, emphasizing the importance of the technique. Although being a valuable option in revision THA, these stems are not free of complications. The high rate of subsidence encountered in our early experience shows that there is a learning curve. This complication is preventable by avoiding undersizing.
authors.affiliation: Department of Orthopedic Surgery, Cleveland Clinic Florida, Weston, Florida, USA.
authors.forename: Preetesh D
authors.initials: PD
authors.lastname: Patel
authors.forename: Alison K
authors.initials: AK
authors.lastname: Klika
authors.forename: Trevor G
authors.initials: TG
authors.lastname: Murray
authors.forename: Karim A
authors.initials: KA
authors.lastname: Elsharkawy
authors.forename: Viktor E
authors.initials: VE
authors.lastname: Krebs
authors.forename: Wael K
authors.initials: WK
authors.lastname: Barsoum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery; D012086:Reoperation