title: Mid-Term Outcomes and Complications with Cementless Distal Locking Hip Revision Stem with Hydroxyapatite Coating for Proximal Bone Defects and Fractures.
abstract: We revised the first 100 revision total hip arthroplasties using a cementless distal locking revision stem conducted in our referral centre. Average follow-up was 9.2 years (range: 5.5-12 years). Harris Hip Score improved from 42.5 to 81.6, and none had thigh pain at last follow-up. No significant stress shielding, osteolysis, or radiologic loosening was found. All patients showed radiological evidence of secondary implant osseointegration. Overall survival was 97% with three patients being revised: two stem ruptures and one subsidence. We could trace these complications to technical errors. These findings suggest that a diaphyseal fixation of the revision stem with distal locking can provide the needed primary axial and rotational stability of the prosthesis. This would allow further bony ingrowth, enhanced by the hydroxyapatite coating.
authors: Department of Orthopaedic Surgery, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain; Reconstructive and Septic Surgery Unit, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
authors: Lluis
authors: L
authors: Carrera
authors: Department of Orthopaedic Surgery, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
authors: Sleiman
authors: S
authors: Haddad
authors: Department of Orthopaedic Surgery, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
authors: Joan
authors: J
authors: Minguell
authors: Department of Orthopaedic Surgery, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain; Reconstructive and Septic Surgery Unit, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
authors: Carles
authors: C
authors: Amat
authors: Department of Orthopaedic Surgery, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain; Reconstructive and Septic Surgery Unit, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
authors: Pablo S
authors: PS
authors: Corona
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D001842:Bone and Bones; D017886:Durapatite / Q000737:chemistry*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D016348:Osseointegration; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D017886:Durapatite
keywords: arthroplasty; bone defect; distal locking; hip; hydroxyapatite; revision