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Complex cemented revision using polished stem and morselized allograft. Minimum 5-years' follow-up
W E Mikhail1, P F Wretenberg, L R Weidenhielm
1Department of Orthopaedic Surgery, Karolinska Hospital, S-171 76 Stockholm, Sweden.
Archives of Orthopaedic and Trauma Surgery
|August 14, 1999
Summary
This study shows that impaction grafting with a cemented, collarless, polished femoral stem is a successful hip revision strategy for severe bone loss, yielding good clinical outcomes at five years.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
Background:
- Complex hip revision surgery addresses severe bone loss.
- Impaction grafting combined with specific femoral stem designs offers a potential solution.
Purpose of the Study:
- To evaluate the outcomes of hip revision using a cemented, collarless, polished femoral stem (CPT) with impaction grafting.
- To assess clinical results and complications in patients with severe bone loss.
Main Methods:
- Retrospective study of 43 hips in 40 patients undergoing revision with impaction grafting and CPT stem.
- Minimum 5-year follow-up.
- Analysis of complications, subsidence, and functional scores (Charnley, D'Aubigne, Postel).
Main Results:
- Good clinical outcomes reported, with significant improvements in pain, function, and movement.
- Early femoral stem subsidence (2-9 mm) occurred in most cases within the first year but was nonprogressive.
- Complications included dislocations, periprosthetic fractures, and aseptic socket loosening, managed successfully.
Conclusions:
- Impaction grafting with the CPT stem is a successful method for hip revision in cases of severe bone loss.
- Despite initial subsidence, the technique provides good functional results at 5-year follow-up.