Modern Revision Femoral Stem Designs Have No Difference in Rates of Subsidence

Subsidence of monoblock and modular titanium fluted tapered stems in revision hip arthroplasty: A retrospective multicentre comparison study

“…In particular, the monoblock stem displayed superior rates when compared to earlier reports of similar stems, with no difference noted when compared to a modular design, in keeping with prior studies on the use of TFT stems. 6,28,29 Regardless of stem design, if using a TFT stem the most important factor to prevent subsidence is surgical technique, and this should be at the forefront of surgeon's minds; both of the stems which subsided in this study were found to be undersized. We suggest that surgeons consider the role of these monoblock stems in the setting or rTHA, as they have comparably low rates of subsidence and the use of monoblock stems, which eliminate modular junctions, removes the small but potentially serious complication of fracture at these modular junctions.…”

Revizyon kalça cerrahisinde femoral sorunlar ve rekonstrüksiyon seçeneklerinin incelenmesi

“…Sonuçlar, iyi primer stabiliteye uyulduğu takdirde, komponent tipinden bağımsız ve tip 1 gibi çok başarılıdır (Şekil 6). [13] Tip 3: Metafiz ve diyafizde ciddi kayıp ve ciddi proksimal femurda remodelling vardır. Bu aşamada da herhangi bir primer femoral komponentin stabil olarak tutunma ihtimali yoktur.…”

“…Bu ayrımın temeli, kullanılacak olan femoral komponentin seçimi ve sağkalımlar arasındaki farktır. [13,14]…”

“…[4] Modüler femoral komponent kullanımı; göreceli olarak kolay uygulanabilir olmasına, her tür gereksinime ve versiyona izin verebilmesine rağmen, eskiden daha sık olsa da günümüzde de hâlâ bağlantı yerlerinde kırılma görülebilmektedir. [13,15] Ayrıca bunlar, monoblok stemlere göre anlamlı düzeyde pahalıdır (Şekil 8). Tip 3B ve 4 femoral revizyonda, çimentosuz komponentler dışında çimentolu komponentlerle de kullanılabilir.…”

Cementless Primary or Revision Stem in the First-time Revision Hip Arthroplasty for Aseptic Stem Loosening? A Retrospective Comparative Study.

“…The study design of most studies that presented the outcome using either cementless primary or revision stem were single-arm, case series 5,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . Although the mid-term implant survival of both primary (85.0% to 96.2%) 7,10,21 and long stem (86.0% to 97.0%) [13][14][15]17,18 were considered good to excellent, the incidence of common complications including surgical site infection (0% vs. 0-7%) 7,10,12,15,21,22 , periprosthetic joint infection (0.7%-5.2% vs. 0-14%) 7,9,16,19 , intraoperative fracture (0.7-20.2% vs. 0-64%) 7,10,12,23 , greater trochanter fracture (3.3% vs. 6.0-19.5%) 8,13,15 , periprosthetic fracture (1.4%-2.1% vs. 1-5%) 5,7,11,14 , stem subsidence (0% vs. 3-19.5%) 7,13,...…”