Article ; Online: The use of a standard-length conical tapered stem in hip revision arthroplasty to address Paprosky type I-II femoral defects: a prospective study of 87 patients.
Archives of orthopaedic and trauma surgery
2023 Volume 143, Issue 9, Page(s) 5945–5955
Abstract: Introduction: Low-grade femoral defects in revision total hip arthroplasty (rTHA) might be preferably treated with a primary implant. Almost no previous study reported the use of standard-length conical tapered (SLCT) stems in these cases. We analyzed a ...
Abstract | Introduction: Low-grade femoral defects in revision total hip arthroplasty (rTHA) might be preferably treated with a primary implant. Almost no previous study reported the use of standard-length conical tapered (SLCT) stems in these cases. We analyzed a series of cases using a SLCT stem in rTHA with Paprosky type I-II femoral defects. The purpose of the study was to determine clinical and radiographic outcomes in this series of rTHA. Materials and methods: We prospectively followed 87 patients undergoing a femoral component rTHA: 53 Paprosky type I and 34 type II femoral defects. Patient-reported measures (Oxford Hip Score, EQ-5D, VAS pain during rest and activity) were administered at baseline, 1 and 2 years post-operatively. Radiographic subsidence overtime was scored. Kaplan-Meier curves were used to evaluate the subsidence over time, the complication-free survival, and the implant survivorship with reoperation and stem revision as endpoints. Results: The mean follow-up was 72.5 (SD ± 23.9) months. All PROMs significatively improved over time. The average subsidence was 2.8 (SD ± 3.2), 3.6 (SD ± 4.4), and 4.0 (SD ± 4.9) mm at 4, 12, and 24 months respectively. 6 stems had subsidence > 10 mm. The survival without complication was 0.85 (95% CI 0.94-0.77), while the implant survival without reoperation was 0.83 (95% CI 0.95-0.72). The overall stem survival rate was 93.7% (95% CI 0.91-0.97) at 2 years. Conclusion: The use of a SLCT stem in rTHA with Paprosky type I-II femoral defects demonstrated good survival with low subsidence rates during the first 2 years after surgery. Surgeons should consider the use of this primary prosthesis as a potential treatment during stem revision in cases with limited femoral bone loss. |
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MeSH term(s) | Humans ; Arthroplasty, Replacement, Hip ; Hip Prosthesis ; Prospective Studies ; Prosthesis Design ; Retrospective Studies ; Reoperation ; Femur/surgery ; Prosthesis Failure ; Treatment Outcome |
Language | English |
Publishing date | 2023-02-20 |
Publishing country | Germany |
Document type | Journal Article |
ZDB-ID | 80407-1 |
ISSN | 1434-3916 ; 0003-9330 ; 0344-8444 |
ISSN (online) | 1434-3916 |
ISSN | 0003-9330 ; 0344-8444 |
DOI | 10.1007/s00402-023-04797-y |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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