Fixationsprinzipien des zementlosen modularen Hüftrevisionsschaftes Revitan

Abstract

Different approaches for implantation lead to different fixation techniques of a curved revision stem. This should be considered by analysing postoperative sintering rates of cementless revision stems.

Modifizierter transfemoraler Zugang zum Wechsel von Hüftendoprothesen mit modularen zementlos implantierbaren Revisionsschäften

“…den SL-Schaft nach H. Wagner [9,10], -modulare Revisionssysteme [5], nämlich Systeme mit Geradschäften [5,9,10] und kurvierten Schäften [5], sowie -Systeme mit Schäften, die im proximalen [4] oder distalen Femur verankert werden [1,5,[9][10][11][12][13]. Wir benutzen das zementlos implantierbare Revitan-System (Zimmer GmbH, Sulzer Allee 8, 8404 Winterthur, Schweiz), das modular entweder als "Revitan Gerade" mit geradem Femurschaft oder als "Revitan Kurviert" mit distal gekrümmtem Femurschaft kombiniert werden kann (Abbildung 1) [5]. Beide Schafttypen werden distal im sog.…”

“…Uncemented revision systems are differentiated as follows: -monoblock implants such as the SL revision stem by H. Wagner [9,10], -modular revision systems [5], namely, systems with straight stems [5,9,10] and curved stems [5], and -systems with stems that are anchored in the proximal [4] or distal femur [1,5,[9][10][11][12][13]. We use the uncemented Revitan system (Zimmer GmbH, Sulzer Allee 8, 8404 Winterthur, Switzerland) that can be assembled in modular technique either as the "Revitan Straight" with a straight femoral stem or as the "Revitan Curved" with a distally curved femoral stem ( Figure 1) [5].…”

“…We use the uncemented Revitan system (Zimmer GmbH, Sulzer Allee 8, 8404 Winterthur, Switzerland) that can be assembled in modular technique either as the "Revitan Straight" with a straight femoral stem or as the "Revitan Curved" with a distally curved femoral stem ( Figure 1) [5]. Both types of stem are anchored in the so-called femoral isthmus, that is, the almost cylindrical, antecurved mid third of the femoral diaphysis.…”

“…Seine Rotationsstabilität wird durch die Ecken (Längsrip-pen) des oktogonalen Querschnitts erreicht. Hierdurch kommt eine Press-fit-Verankerung im Isthmus femoris zustande [5]. der to avoid anterior perforation of the femur [1,10].…”

Pros and Cons of Spacers in the Treatment of Late Periprosthetic Infections of the Hip

“…Since the optimal interdigitation of the cement requires a spongiform structure to the bone, and this is not found after debridement, especially in the femoral component, it is likely that the quality of the long-term fixation of the cemented prosthesis will be diminished by the presence of smooth bone surfaces. Although there are no reports concerning aseptic loosening of cemented re-implants following two-stage septic revision arthroplasty, we know that the rate of loosening of cemented revision stems is much higher than that of cementless stems [51,52]. We therefore use cementless revision stems for reimplantation and it is the disadvantages of cemented reimplantations that have persuaded us to choose a two-stage procedure in preference to the one-stage procedure for hip joint revision, although not for knee revisions.…”