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Long-term results of revision total hip arthroplasty with a cemented femoral component

Armin Pallaver1, Lukas Zwicky2, Lilianna Bolliger1

  • 1Clinic for Orthopedic and Trauma Surgery, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland.

Archives of Orthopaedic and Trauma Surgery
|August 13, 2018
PubMed

Insights

Revision total hip arthroplasty (THA) using cemented straight stems demonstrated excellent long-term survival and radiological outcomes. This implant provides a valuable, cost-effective option for revision THA procedures.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Medical Device Technology

Background:

  • Revision total hip arthroplasty (THA) often involves complete removal of femoral cancellous bone.
  • Some advocate metaphyseal bone removal for enhanced press-fit stability in revision THA.
  • The study evaluates a specific cemented straight stem in revision THA.

Purpose of the Study:

  • To investigate the long-term survival and radiological outcomes of a cemented straight stem in revision THA.
  • To compare these outcomes with the same stem's performance in primary THA.
  • To assess the stem's suitability as a cost-effective option for revision procedures.

Main Methods:

  • Retrospective analysis of 178 revision THA cases using the Virtec straight stem (1994-2008).
  • Cumulative incidence of re-revision calculated using competing risk models.
  • Radiographic assessment for osteolysis, debonding, and subsidence at minimum 10-year follow-up.

Main Results:

  • 10-year cumulative incidence for aseptic loosening re-revision was 5.5%.
  • Aseptic loosening correlated with younger age, larger defect size, and larger stem size.
  • Osteolysis observed in 39 of 80 revision THA at minimum 10-year follow-up; survival inferior to primary THA.

Conclusions:

  • Cemented straight stems show excellent long-term survivorship and radiological results in revision THA.
  • The Virtec straight stem is a valuable and cost-effective choice for revision THA.
  • Findings support the use of this stem despite slightly inferior survival compared to primary THA.
Abstract

Keywords:
Cemented revision THAFrench paradoxStraight stem

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