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The use of a standard-length conical tapered stem in hip revision arthroplasty to address Paprosky type I-II femoral defects: a prospective study of 87 patients.
Innocenti, Matteo; Smulders, Katrijn; Andreotti, Mattia; Willems, Jore H; Van Hellemondt, Gijs; Nijhof, Marc W.
Afiliación
  • Innocenti M; Department of Orthopaedic Surgery, University of Florence, Florence, Italy. innocenti.matteo11@gmail.com.
  • Smulders K; Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands.
  • Andreotti M; Department of Orthopaedic, Ospedale Riuniti Padova, Padua, Italy.
  • Willems JH; Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands.
  • Van Hellemondt G; Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands.
  • Nijhof MW; Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands.
Arch Orthop Trauma Surg ; 143(9): 5945-5955, 2023 Sep.
Article en En | MEDLINE | ID: mdl-36806987
INTRODUCTION: Low-grade femoral defects in revision total hip arthroplasty (rTHA) might be preferably treated with a primary implant. Almost no previous study reported the use of standard-length conical tapered (SLCT) stems in these cases. We analyzed a series of cases using a SLCT stem in rTHA with Paprosky type I-II femoral defects. The purpose of the study was to determine clinical and radiographic outcomes in this series of rTHA. MATERIALS AND METHODS: We prospectively followed 87 patients undergoing a femoral component rTHA: 53 Paprosky type I and 34 type II femoral defects. Patient-reported measures (Oxford Hip Score, EQ-5D, VAS pain during rest and activity) were administered at baseline, 1 and 2 years post-operatively. Radiographic subsidence overtime was scored. Kaplan-Meier curves were used to evaluate the subsidence over time, the complication-free survival, and the implant survivorship with reoperation and stem revision as endpoints. RESULTS: The mean follow-up was 72.5 (SD ± 23.9) months. All PROMs significatively improved over time. The average subsidence was 2.8 (SD ± 3.2), 3.6 (SD ± 4.4), and 4.0 (SD ± 4.9) mm at 4, 12, and 24 months respectively. 6 stems had subsidence > 10 mm. The survival without complication was 0.85 (95% CI 0.94-0.77), while the implant survival without reoperation was 0.83 (95% CI 0.95-0.72). The overall stem survival rate was 93.7% (95% CI 0.91-0.97) at 2 years. CONCLUSION: The use of a SLCT stem in rTHA with Paprosky type I-II femoral defects demonstrated good survival with low subsidence rates during the first 2 years after surgery. Surgeons should consider the use of this primary prosthesis as a potential treatment during stem revision in cases with limited femoral bone loss.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Prótesis de Cadera Tipo de estudio: Observational_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Arch Orthop Trauma Surg Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Prótesis de Cadera Tipo de estudio: Observational_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Arch Orthop Trauma Surg Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania