Endofemoral Shooting Technique for Removing Well-fixed Cementless Stems

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Implant retrieval

Background:

• Cementless femoral stems in hip arthroplasty can become well-fixed, making removal challenging during revision procedures.
• Established techniques for revision surgery are crucial for successful patient outcomes.

Purpose of the Study:

• To evaluate the outcomes of a specific endofemoral extraction technique for removing well-fixed cementless femoral stems.
• To assess the long-term success and complications associated with this retrieval method.

Main Methods:

• A retrospective study of 106 patients (108 hips) undergoing cementless femoral stem removal between 2001 and 2016.
• The endofemoral extraction technique involved sequential Kirschner wire insertion and chisel detachment.
• Post-removal, stems were replaced with cemented stems, with autografting as needed. Radiological loosening and prosthesis survival were analyzed.

Main Results:

• Re-revision surgery was required in 7 hips.
• Stem loosening occurred in 4 hips, with a mean subsidence of 0.3 mm.
• The 10-year prosthesis survival rate was 97.7%.

Conclusions:

• The endofemoral extraction technique provides successful outcomes for removing well-fixed cementless femoral stems.
• This method demonstrates a high survival rate, indicating its efficacy in revision hip arthroplasty.