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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
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Femoral revision with a primary cementless stem
O Gastaud1, P M Cambas1, J Tabutin1
1Centre hospitalier de Cannes, 15, avenue des Broussailles, CS 5008, 06414 Cannes cedex, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|February 15, 2016
Summary
Revision total hip arthroplasty using a primary cementless femoral stem shows good bone fixation and survival rates. This technique is suitable for specific bone defect grades, requiring careful surgical planning.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
Background:
- Revision total hip arthroplasty (reTHA) often presents challenges in achieving stable femoral component fixation.
- Primary cementless femoral stems are considered for reTHA, but their outcomes require further investigation.
Purpose of the Study:
- To evaluate the bone fixation, subsidence, loosening rates, and survival of primary anatomical cementless femoral stems in reTHA.
- To determine the efficacy of this approach for specific bone defect classifications.
Main Methods:
- A retrospective study of 43 reTHA procedures using primary cementless femoral stems.
- Patients had Paprosky grade 1 or 2A bone defects.
- Clinical outcomes (PMA, Harris scores) and radiological assessments (subsidence) were analyzed.
Main Results:
- Significant improvements in clinical scores (PMA and Harris) were observed post-revision.
- No extensive radiolucencies or secondary subsidence were noted.
- Estimated 80-month survival rate was 85% (95% CI: 64-100%).
Conclusions:
- Primary cementless femoral stems can achieve adequate bone fixation and satisfactory survival in reTHA for Paprosky grades 1 and 2A.
- The technique necessitates good metaphyseal bone quality and meticulous preoperative planning.
- Surgeons should be prepared with revision components if needed.
