title: Clinical experience in femoral revision with the modular Profemur R stem.
abstract: The application of modular femoral stems is constantly increasing in revision hip surgery. From March 2001 to March 2006, we employed the Profemur R modular stem in 35 cases of femoral component revision (31 first revisions and 4 re-revisions). The reasons for revision surgery included aseptic loosening in 17 cases, periprosthetic femoral fracture in 8 cases, stem fracture in 3 cases, septic loosening in 2 cases and recurrent dislocation in 1 case. According to the Merle d'Aubugne-Postel score clinical results were very good in 11 cases, good in 9 cases, medium in 5 cases, fair in 4 cases and poor in 4 cases. The main complications included 2 intraoperative diaphyseal fractures treated with multiple cerclage wires and 2 early infections treated with debridement and prolonged antibiotic therapy. One fracture healed in association with temporary wound discharge, and the other resulted in non-union with a femoral varus deformity. This required revision with internal fixation (LCP plate) at 3 months, with a successful result. In one case of stem subsidence femoral revision with a larger Profemur R implant was required. In our retrospective study the Profemur R modular stem has been an effective prosthetic system for femoral reconstruction in case of loosening with Paprosky grade III bone loss and following periprosthetic femoral fractures.
authors.affiliation: Department of Orthopaedics and Traumatology, Institute of Orthopaedic Surgery Regina Maria Adelaide, Turin, Italy. stefartiaco@libero.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Artiaco
authors.forename: Frediano
authors.initials: F
authors.lastname: Boggio
authors.forename: Paolo
authors.initials: P
authors.lastname: Titolo
authors.forename: Kristjian
authors.initials: K
authors.lastname: Zoccola
authors.forename: Pasquale
authors.initials: P
authors.lastname: Bianchi
authors.forename: Franco
authors.initials: F
authors.lastname: Bellomo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome