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Component removal in revision total hip arthroplasty.
W G Paprosky1, S H Weeden, J W Bowling
1Rush Medical College, Chicago, IL, USA.
Clinical Orthopaedics and Related Research
|January 5, 2002
Summary
Revision hip arthroplasty involves challenging component removal. This study reviews techniques for extracting acetabular and femoral components, finding that careful planning ensures successful revision surgery with manageable complication rates.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Arthroplasty Research
Background:
- Revision hip arthroplasty necessitates the removal of previously implanted components.
- Extraction of well-fixed implants and cement presents significant surgical challenges, potentially damaging host bone.
Purpose of the Study:
- To analyze operative techniques for acetabular and femoral component extraction during hip revision.
- To review outcomes of revision hip arthroplasty following cementless component removal.
Main Methods:
- Retrospective review of 157 acetabular and 113 femoral components from 219 patients (1985-2000).
- Analysis of implant removal techniques and associated complications.
- Average follow-up of 5 years.
Main Results:
- 14 acetabular failures (5%) required reoperation; no femoral rerevisions occurred.
- Complications included dislocation (6-9%), infection (6%), femoral fracture (6%), and hematoma (3.5%).
- Femoral osteolysis occurred in 1% of cases.
Conclusions:
- Successful removal of cemented and well-fixed porous-coated implants is achievable.
- Adequate preoperative planning and knowledge of diverse implant removal techniques are crucial for effective revision hip arthroplasty.