Mid-term Results of Revision Total Hip Arthroplasty Using Modular Cementless Femoral Stems

Jang, Hyung-Gyu; Lee, Kyung-Jae; Min, Byung-Woo; Ye, Hee-Uk; Lim, Kyung-Hwan

doi:10.5371/hp.2015.27.3.135

Cited by 16 publications

(8 citation statements)

References 33 publications

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“…In spite of satisfactory clinical results consistent with previous studies [7,28,32,33], we identi ed some complications. Instability was reported in 6% of the cases.…”

Section: Discussionsupporting

confidence: 84%

Implant Breakage Risk for Modular Fluted Tapered Stems in Revision Total Hip Arthroplasty at 5-Year Follow-Up

Lucena¹,

Cavaignac²,

Chiron³

et al. 2020

Preprint

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Background: Modular stems in revision total hip arthroplasties allow diaphyseal fixation and optimal restoration of the architecture of the proximal femur. Several studies report metaphyseal implant breakage in the mid- to long-term and therefore a huge impact on survivorship. We aimed to evaluate a specific design of uncemented modular fluted tapered stems (MFT) to analyze survivorship and clinical and radiological outcomes.Methods: In a retrospective study, we identified 99 patients who had surgery using the same design of MFT implant between 2012 and 2014. Patients were mainly male in 53% and mean age was 73 years. Indications were 33 aseptic loosening, 24 periprosthetic fractures, 23 periprosthetic joint infection, 1 instability and 18 were complex primary arthroplasties. Survivorship, complications and clinical outcomes, were assessed. Mean follow-up was 5 years.Results: There was no implant breakage. At 5-year follow-up, the survivorship free of revision for aseptic loosening and free of revision for any reason of the femoral stem were 100% and 99%, respectively. At last follow-up, they were 94% and 81%, respectively. Six implants were revised. A mean stem subsidence of 6 mm was noted in 9 cases; 1 was revised for aseptic loosening. The Harris hip score was 89. The risk of revision was significantly higher for shorter diaphyseal implants (p=0.026).Conclusion: At mid-term follow-up of 5 years, the MFT studied reported an excellent survivorship and clinical outcomes with no specific complications. Unlike literature reports, no specific complications occurred with this design. Satisfying clinical outcomes and limited subsidence are consistent with previous reports though.Level of evidence: IV – Case series

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“…In spite of satisfactory clinical results consistent with previous studies [7,28,32,33], we identi ed some complications. Instability was reported in 6% of the cases.…”

Section: Discussionsupporting

confidence: 84%

Implant Breakage Risk for Modular Fluted Tapered Stems in Revision Total Hip Arthroplasty at 5-Year Follow-Up

Lucena¹,

Cavaignac²,

Chiron³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Fink et al (11) reported all-cause implant survival at 7.5 years to be 91.4% (95% CI, 86.2%-96.6%). In their cohort of 45 patients (47 hips), Jang et al (24) revised 5 hips for deep infection and 2 hips for dislocation. The 8-year survival rate, with revision for any reason as an event of interest, was 86%.…”

Section: Discussionmentioning

confidence: 99%

Mid-term results of revision total hip arthroplasty with an uncemented modular femoral component

et al. 2017

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“…Huddleston et al (21) reported lower revision rate for modular stems, whilst Mertl et al (10) found a higher rate of failure for MNFS. However, compared to monolithic stems, modular implants greatly simplify strategies for revision THA and following failures of revision as the modular neck can be removed, facilitating exposure and replaced easily to adapt offset, limb length and NSA while leaving the intramedullary part of the stem stably fixed within the femur, which has relatively good bone quality at mid-term followup (42,(49)(50)(51).…”

Section: Discussionmentioning

confidence: 99%

Mid-term outcomes of titanium modular neck femoral stems in revision total hip arthroplasty

Ouanezar¹,

Jalaguier²,

Franck³

et al. 2019

Ann. Transl. Med

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Background: Modular stems have been widely studied as they allow intraoperative adjustments (offset, anteversion, limb length) to better restore hip biomechanics. Many authors reported outcomes of revision total hip arthroplasty (THA) using modular stems with metaphyseal-diaphyseal junctions, however, little is known about modular neck femoral stems (MNFS) with metaphyseal-epiphyseal junctions. We therefore aimed to report outcomes and implant survival of a MNFS in a consecutive series of revision THA at a minimum follow-up of 5 years. Methods: We reviewed a consecutive series of 28 revision THAs performed between February 2010 and March 2012 using an uncemented MNFS. The final study cohort included 25 patients living with their original components, at a mean follow-up of 68.4±7.4 months and aged 67.7±11.6 years at index operation. Results: The Harris Hip Score (HHS) improved from 39.1±19.2 pre-operatively to 78.1±18.3 postoperatively, and the Postel Merle d'Aubigné score (PMA) improved from 9.8±3.0 pre-operatively to 14.8±2.8 post-operatively. The postoperative limb length discrepancy (LLD) was >10 mm in 18% of the hips. There were no significant differences of femoral offset and neck shaft angle (NSA) between operated and contralateral hips. Two hips (8.0%) showed new periprosthetic radiolucent lines. Periprosthetic fractures (PPF) occurred in 3 hips (12%). No subluxations, dislocations or implant breakages were reported. One revision (3.6%) was performed with retrieval of the revision stem for infection. The Kaplan-Meier (KM) survival at 5 years, using stem revision as endpoint, was 96.0%. Conclusions: The Optimal ® MNFS provided a satisfactory survival and clinical outcomes at 5 years, with no noticeable adverse effects resulting from the additional modular junction.

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Mid-term Results of Revision Total Hip Arthroplasty Using Modular Cementless Femoral Stems

Cited by 16 publications

References 33 publications

Implant Breakage Risk for Modular Fluted Tapered Stems in Revision Total Hip Arthroplasty at 5-Year Follow-Up

Implant Breakage Risk for Modular Fluted Tapered Stems in Revision Total Hip Arthroplasty at 5-Year Follow-Up

Mid-term results of revision total hip arthroplasty with an uncemented modular femoral component

Mid-term outcomes of titanium modular neck femoral stems in revision total hip arthroplasty

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