A Role for Modern Primary Cementless Femoral Stems in Revision Hip Arthroplasty.
Publication/Presentation Date
9-1-2021
Abstract
BACKGROUND: In revision total hip arthroplasty (THA) cases with preserved femoral metaphyseal bone, tapered proximally porous-coated "primary" femoral stems may be an option. The objective of this study was to compare outcomes of patients with Paprosky I or II femoral bone loss undergoing revision THA with either a primary metaphyseal-engaging cementless stem or a revision diaphyseal-engaging stem.
METHODS: This was a retrospective analysis of 70 patients with Paprosky I or II femoral bone loss who underwent femoral revision. 35 patients who were revised using a primary cementless femoral stem were compared with 35 patients who underwent femoral revision using a revision diaphyseal-engaging stem. The groups were similar regarding age, gender, body mass index, and American Society of Anesthesiologists. Clinical and radiographic outcomes and complications were compared over an average follow-up of 2.9 years (SD 1.4).
RESULTS: Revision THA was most commonly performed for periprosthetic joint infection (N = 27, 38.6%). The groups were similar with regards to Paprosky femoral classification (P = .56), length of stay (P = .68), discharge disposition (P = .461), operative time (P = .20), and complications (P = .164). There were no significant differences between primary and revision femoral stem subsidence (0.12 vs. 0.75 mm, P = .18), leg length discrepancy (2.3 vs. 4.05 mm, P = .37), and Hip Disability and Osteoarthritis Outcome Score Jr (73.1 [SD 21.1] vs. 62.8 [SD 21.7], P = .088). No patient underwent additional revision surgery involving the femoral component.
CONCLUSION: Use of modern primary cementless femoral stems is a viable option for revision hip arthroplasty in the setting of preserved proximal femoral metaphyseal bone. Outcomes are not inferior to those of revision stems and offer potential benefits.
Volume
36
Issue
9
First Page
3269
Last Page
3274
ISSN
1532-8406
Published In/Presented At
Skibicki, H. E., Post, Z. D., Kay, A. B., Czymek, M. M., Ong, A. C., Orozco, F. R., & Ponzio, D. Y. (2021). A Role for Modern Primary Cementless Femoral Stems in Revision Hip Arthroplasty. The Journal of arthroplasty, 36(9), 3269–3274. https://doi.org/10.1016/j.arth.2021.04.042
Disciplines
Medicine and Health Sciences
PubMedID
34053749
Department(s)
Department of Surgery
Document Type
Article