Extensively porous-coated stems for femoral revision: reliable choice for stem revision in Paprosky femoral type III defects.
Between January 1999 and August 2008, ninety-six femoral revisions were performed with extensively porous-coated stems in Paprosky type III femoral defects (89 type IIIA and 7 type IIIB defects). Seven type IIIB defects with a mean canal of 16.5 mm were observed; 6 defects achieved stable bone ingrowth and 1 achieved stable fibrous condition. Average postoperative Harris Hip Score was 92.3±8 (range, 77-100), and all scores improved postoperatively. At a mean follow-up of 65.7 months, 92 stems achieved bone ingrowth, and 1 stem (type IIIB) achieved a stable fibrous condition. Three patients died from causes unrelated to the surgery during follow-up. The most frequent diagnosis for revision of the femoral component was loosening of the cementless stem (53 patients; 55.2%), followed by status after a Girdlestone procedure (21 patients; 21.8%), after total hip arthroplasty with acetabular wear (10 patients; 10.4%), loosening of the cemented stem (7 patients; 7.3%), and periprosthetic fracture (5 patients; 5.2%). The authors performed 65 total hip arthroplasty revisions, 23 femoral component revisions, and 8 revisions of femoral components with cemented liners in patients with well-fixed acetabular shells. Extensively porous-coated stems in femoral revision for Paprosky type III femoral defects provided good mid-term durability.
Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taiwan.
Lien-Hsiang
LH
Chung
Po-Kuei
PK
Wu
Cheng-Fong
CF
Chen
Wei-Ming
WM
Chen
Tain-Hsiung
TH
Chen
Chien-Lin
CL
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D019544:Equipment Failure Analysis; D005260:Female; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016062:Porosity; D015995:Prevalence; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult
D020099:Coated Materials, Biocompatible