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

Fink, Bernd; Grossmann, Alexandra

doi:10.1007/s00064-007-1194-6

Cited by 34 publications

(11 citation statements)

References 8 publications

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“…Our short-term results are well in line with those of Fink et al regarding subsidence and stem fixation; they also used a modular revision stem (Revitan Curved, Zimmer, Switzerland), which similarly resulted in reproducibly good results with respect to clinical outcome, fracture healing, subsidence, and dislocation [10]. Similar to us, Fink et al used a modified transfemoral approach with an extended trochanteric osteotomy [3,12,18,21] and demonstrated good mid-term results in 28-44 patients [25 -27]. Comparable results have been described by El-Bakoury et al with a distally locked revision stem and an extended trochanteric osteotomy, with a fracture healing rate of 95.8 % [25].…”

Section: Original Articlesupporting

confidence: 85%

“…Before addressing the fracture, the acetabular component was checked for loosening or wear and revised if necessary. Stem extraction was performed via a modified transfemoral approach [18], with a transfemoral stem removal through the fracture, followed by stabilization of the femoral shaft by cerclages wires, fracture reduction, and final implantation of the revision stem. Intraoperative swabs were obtained during every surgery.…”

Section: Surgical Approach Implant and Postoperative Protocolmentioning

confidence: 99%

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Hip Revision Arthroplasty of Periprosthetic Fractures Vancouver B2 and B3 with a Modular Revision Stem: Short-Term Results and Review of Literature

Schreiner

Steidle

Schmidutz³

et al. 2020

Z Orthop Unfall

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Background Periprosthetic fractures Vancouver type B2/B3 after total hip arthroplasty (THA) is a challenging entity with increasing numbers. Limited data are available for this type of fracture treated with modular stems. Therefore, this study evaluated the outcome of Vancouver type B2/B3 fractures treated with a modular hip revision stem using a subproximal/distal anchorage and compared it to the current literature. Materials and Methods A consecutive series of periprosthetic Vancouver type B2/B3 fractures treated with a modular revision stem was retrospectively (2013 – 2016) evaluated. Assessment included the clinical (HHS, pain, ROM) as well as the radiological outcome (subsidence, loosening, facture healing). In adddition, the surgical technique is described in detail and results are compared with the current literature. Results A total of 18 patients (female/male 12/6) with Vancouver B2/B3 (n = 12/6) fractures with a mean age of 75.5 (60 – 89) years were included. The revision stem was inserted via a modified transgluteal approach (n = 16) or classical transfemoral approach (n = 2). The mean follow-up was 18.5 months, with a mean Harris Hip Score of 72.5 ± 18.7 (35.0 – 99.0) points. The fracture healing rate was 94.4% (n = 17) with osseous integration according to Engh in all cases. Dislocations of the greater trochanter were recorded in seven patients (38.9%). According to Beals and Towers, all results were rated excellent or good. No implant-related failure or relevant subsidence during this time was observed. Major complications were observed in five patients with two periprosthetic joint infections and two cases of major revision surgery. Conclusion This study assessing Vancouver B2/3 fractures shows reproducible, good, short-term results in terms of subsidence and clinical functional outcome by the use of a modular revision stem. The transfemoral approach together with the modular stem allows for a stable fixation and good fracture healing. However, our data and review of the literature also documents the difficulties and higher complication rate associated with Vancouver B2/3 fractures.

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Section: Original Articlesupporting

confidence: 85%

Section: Surgical Approach Implant and Postoperative Protocolmentioning

confidence: 99%

Hip Revision Arthroplasty of Periprosthetic Fractures Vancouver B2 and B3 with a Modular Revision Stem: Short-Term Results and Review of Literature

Schreiner

Steidle

Schmidutz³

et al. 2020

Z Orthop Unfall

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“…The direct posterior as well as transfemoral surgical approaches are dependent on the linea aspera as a fixed anatomical landmark during the surgical procedure [4, 5]. Additionally, arthroplasty surgeons concerned with the cardiopulmonary complications of fat embolism are careful not to disrupt the venous drainage system located along the linea aspera, thereby reducing the risk of intraoperative embolism [6, 7].…”

Section: Discussionmentioning

confidence: 99%

The linea aspera as a guide for femoral rotation after tumor resection: is it directly posterior? A technical note

Abdelaal

Yamamoto

Hayashi

et al. 2016

J Orthopaed Traumatol

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BackgroundThe linea aspera is the rough, longitudinal crest on the posterior surface of the femoral shaft. Most orthopedic surgeons depend on the linea aspera as an intraoperative landmark identifying the true posterior aspect of the femur. We investigated the position of the linea aspera to verify whether the surgeon can rely on this accepted belief.Material and methodOne hundred and thirty-three femora from 73 patients were evaluated. Four CT cuts were done of the mid femur, and we measured the angle of rotation of the linea aspera at each cut.ResultsThe linea aspera was externally rotated in most femora evaluated; average angles of rotation were 15.4°, 14°, 11.7°, and 11.5° at 10, 15, 20, and 25 cm from the intercondylar line, respectively. The angle of rotation of the linea aspera was positively correlated with femoral neck anteversion angle and negatively with age.ConclusionThe linea aspera is exactly posterior in a minority of individuals, while it is externally rotated to varying degrees in the majority of individuals. The degree of rotation was positively correlated with femoral neck anteversion angle, and negatively with age. To avoid implant malrotation, accurate estimation of the rotation angle should be determined preoperatively.Level of evidenceLevel IV.

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“…Bei den drei letztgenannten Fällen musste eine Beckendiskontinuität vor der Implantation der Burch-Schneider-Rings mit Rekonstruktionsplatten stabilisiert werden (Abbildungen 13a bis 13d). In 14 Fällen war gleichzeitig eine Prothesenschaftwechsel notwendig, sechsmal über einen transfemoralen Zugang [5]. Als Ringgrößen kamen einmal eine 44er, 20-mal eine 50er, achtmal eine 56er und einmal eine 62er Größe zum Einsatz.…”

Section: Postoperative Behandlungunclassified

Pfannenwechsel bei größeren Defekten mit Antiprotrusionsringen

Fink¹,

Grossmann²,

Sebena³

2010

Orthop Traumatol

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

Cited by 34 publications

References 8 publications

Hip Revision Arthroplasty of Periprosthetic Fractures Vancouver B2 and B3 with a Modular Revision Stem: Short-Term Results and Review of Literature

Hip Revision Arthroplasty of Periprosthetic Fractures Vancouver B2 and B3 with a Modular Revision Stem: Short-Term Results and Review of Literature

The linea aspera as a guide for femoral rotation after tumor resection: is it directly posterior? A technical note

Pfannenwechsel bei größeren Defekten mit Antiprotrusionsringen

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