title: Femoral revision with taper stems: results at ten years follow-up.
abstract: In the case of extensively damaged meta-diaphyseal femoral bone with cortices thinning and widened femoral canal, tapered stems allow a good primary fixation and early weight-bearing. A retrospective review was conducted to evaluate long-term results of modular revision taper stems implanted from March 1999 to December 2002. Sixty-five consecutive hip revision surgeries were performed, mostly for aseptic loosening (75% of the cases). Femoral bone stock defects were classified according to AAOS's criteria and consisted mainly in type II (cavitary defects, 44.6%) and type III (combined defects, 33.9%). A trochanteric osteotomy was performed in 25 cases (38%) to remove primary implants that were cemented in 35 cases (54%). The mean postoperative follow-up was 109 months (range, 76 to 131 months). Clinical assessment at follow-up showed a significantly improved mean Harris Hip Score from 42 points preoperatively to 81 points postoperatively, while the x-ray examination did show a satisfactory distal integration of the stem in all cases and satisfactory reconstitution of the femoral bone stock in 47% of cases. The average subsidence of the stem at follow-up was less than one millimeter. According to data analysis, a leg-length discrepancy exceeding 15 millimeters caused significantly worse functional outcome and pain.
authors.affiliation: Department of Orthopedics, University of Insubria, Varese, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cherubino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fagetti
authors.forename: Fabio
authors.initials: F
authors.lastname: D'Angelo
authors.forename: Michele Francesco
authors.initials: MF
authors.lastname: Surace
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000601:surgery*; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome