RESUMEN
INTRODUCTION: The aim of this study was to analyze the survival of the Echelon® femoral stems in revision hip surgeries in patients with Paprosky I-IIIA femoral defects. PATIENTS AND METHODS: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32-83) years, and the mean follow-up period was 93 (45-206) months. The reasons for revision were aseptic loosening in 55 (78.6%) patients, periprosthetic joint infection in 9 (12.9%) patients, periprosthetic fracture in 4 (5.7%) patients, and stem fracture in 2 (2.9%) patients. The preoperative and postoperative follow-up X-rays and functional scores were evaluated. RESULTS: Five patients died in an average of 70 (45-86) months after surgery due to non-related diseases. We encountered sciatic nerve palsy in two patients and early hip dislocation in two patients, whereas 54 patients were able to walk without any assistive device. The remaining 12 patients required an assistive device to walk. The mean Harris hip score significantly increased from 34 (7-63) preoperatively to 72 (43-96) postoperatively. Aseptic loosening was observed in one patient. The survival of the porous-coated anatomical uncemented femoral stem was 98.4% over 10 years. CONCLUSION: This study showed that good clinical outcomes and survival can be obtained when using porous-coated anatomical uncemented femoral stems.
Asunto(s)
Artroplastia de Reemplazo de Cadera/instrumentación , Materiales Biocompatibles Revestidos , Fémur/cirugía , Luxación de la Cadera/cirugía , Fracturas Periprotésicas/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fémur/diagnóstico por imagen , Estudios de Seguimiento , Luxación de la Cadera/diagnóstico , Prótesis de Cadera , Humanos , Masculino , Persona de Mediana Edad , Porosidad , Diseño de Prótesis , Radiografía , Reoperación , Factores de TiempoRESUMEN
Periprosthetic joint infection (PJI) due to Salmonella is rare. It frequently occurs patients receiving immunosuppressive medicine. We describe two periprosthetic Salmonella infection of two immunocompromised patients. Both of patients were receiving azathioprine and prednisolone therapy. First patient presented six years after total hip arthroplasty with a huge abscess on her right thigh that was reached to femoral component through the lytic area of lateral femur. Second patient presented with drainage from his hip and he had undergone two-step revision surgery for PJI 3 months ago. There is no consensus in the treatment of periprosthetic salmonella infections. We prefer two-step revision surgery for these infections as previously described in the literature.