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Revision hip surgery using the straight-stem Muller prosthesis.

S B Goodman, J Schatzker

    The Journal of Arthroplasty
    |January 1, 1987
    PubMed
    Summary
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    Revision hip arthroplasty using the Muller straight-stem prosthesis achieved good to excellent results in 72% of patients. Outcomes were superior when revising from resurfacing arthroplasty, though trochanteric osteotomy complications were noted.

    Area of Science:

    • Orthopedic Surgery
    • Biomaterials Science
    • Clinical Outcomes Research

    Background:

    • Revision hip arthroplasty is a complex procedure to address failed primary hip replacements.
    • The Muller straight-stem prosthesis is one option for cemented femoral fixation in revision cases.
    • Acetabular reconstruction often requires augmentation like support rings, mesh, or bone grafts.

    Purpose of the Study:

    • To evaluate the clinical and radiographic outcomes of cemented revision hip arthroplasty using the Muller straight-stem prosthesis.
    • To compare outcomes based on the type of previous hip arthroplasty.
    • To identify complications associated with the procedure, particularly regarding trochanteric osteotomy.

    Main Methods:

    • Retrospective review of 32 cemented revision hip arthroplasties with a Muller straight-stem prosthesis.

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  • Average follow-up of 3 years (range, 2-4.4 years).
  • Clinical assessment using the Swanson and Evarts rating system; radiographic evaluation for component loosening.

    • Main Results:

    • Overall, 65.6% excellent, 6.3% good, 25% fair, and 3.1% poor clinical results were observed.
    • Revision from resurfacing arthroplasty yielded 87.5% good/excellent outcomes, compared to 60% from other primary arthroplasties.
    • Radiographic evidence of loosening in three components (two femoral, one acetabular) in patients with fair clinical ratings.
    • High rates of trochanteric wire breakage (60%) and displacement (26.7%) when trochanteric osteotomy was performed.

    Conclusions:

    • Cemented Muller straight-stem prosthesis can provide satisfactory outcomes in revision hip arthroplasty.
    • Previous arthroplasty type significantly influences clinical success.
    • Trochanteric osteotomy in this context is associated with a high risk of wire complications, warranting careful consideration.