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Revision total hip replacement using the S-ROM femoral component
H P Chandler1, D K Ayres, R C Tan
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA.
Clinical Orthopaedics and Related Research
|October 1, 1995
Summary
The S-ROM femoral component effectively addressed complex hip revision challenges, including severe bone loss and instability. This modular prosthesis demonstrated good patient satisfaction and durability in difficult cases.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Complex total hip revisions present significant challenges due to severe bone loss, instability, and leg length discrepancies.
- Previous hip surgeries and complications like sepsis further complicate revision arthroplasty.
Purpose of the Study:
- To evaluate the efficacy and safety of the proximally porous-coated, modular S-ROM femoral component in complex total hip revisions.
- To assess outcomes in patients with substantial bone loss, instability, and prior surgical history.
Main Methods:
- Utilized the S-ROM femoral component in 52 complex total hip revisions across 48 patients.
- Employed structural femoral allografts in 22 patients and selective cementing of the metaphyseal sleeve.
- Assessed patient outcomes using the Harris Hip Score and radiographic/histologic evaluation.
Main Results:
- Achieved a significant improvement in Harris Hip Score from 44 preoperatively to 82 at mean 3-year follow-up.
- Reported 84% patient satisfaction with no evidence of fretting at the modular junction.
- Observed complications including bursitis, nonunion, fractures, dislocations, and loosening, but none attributable to the S-ROM component itself.
Conclusions:
- The modular S-ROM femoral component is a versatile and effective option for complex hip revisions, even in cases with severe bone loss and instability.
- While complications are not infrequent in these challenging cases, the S-ROM component demonstrated good performance and durability.