Global fit concept in revision hip arthroplasty for cementless press-fit femoral stems.
A revision stem may be required after a femoral extended trochanteric osteotomy (ETO) is made during revision hip arthroplasty. The two main complications of straight cementless femoral stems are subsidence due to inadequate osteointegration and stress-shielding. We will describe an original revision method with ETO that uses a straight cementless stem. The goal of this method was to achieve the most extensive press-fit possible during stem implantation to improve the transmission of stresses to the bone and to prevent reduction in bone density. The intramedullary preparation was done after closure and fixation of the ETO, which allows impaction of the revision stem with metaphyseal and diaphyseal press-fit. We report encouraging results with preservation of periprosthetic bone stock and good osteointegration of these revision stems at the final follow-up. Pronounced sagittal curvature or large bone defects are contraindications for this technique.
Unité de chirurgie du membre inférieur, département de chirurgie orthopédique et traumatologie, hôpital Lapeyronie, CHRU de Montpellier, 371, avenue Gaston-Giraud, 34295 Montpellier cedex 5, France.
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Canovas
11, Galeries du Théâtre, 35000 Rennes, France.
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LeBeguec
Unité de chirurgie du membre inférieur, département de chirurgie orthopédique et traumatologie, hôpital Lapeyronie, CHRU de Montpellier, 371, avenue Gaston-Giraud, 34295 Montpellier cedex 5, France.
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Batard
Unité de chirurgie du membre inférieur, département de chirurgie orthopédique et traumatologie, hôpital Lapeyronie, CHRU de Montpellier, 371, avenue Gaston-Giraud, 34295 Montpellier cedex 5, France.
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Gaillard
Unité de chirurgie du membre inférieur, département de chirurgie orthopédique et traumatologie, hôpital Lapeyronie, CHRU de Montpellier, 371, avenue Gaston-Giraud, 34295 Montpellier cedex 5, France. Electronic address: louisdagneaux@gmail.com.
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Dagneaux
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001843:Bone Cements; D015519:Bone Density; D005260:Female; D005269:Femur / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods; D010865:Pilot Projects; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome
D001843:Bone Cements
Cementless stem; Global fit; Hip prosthesis; Press-fit; Revision arthroplasty