Primary cementless stems in septic hip revision: Indications and results

Abstract

Purpose: The aim of our work is to evaluate results obtained from a cohort of patients affected by periprosthetic joint infection and treated with a primary cementless stem in a two-stage technique framework. Methods: Eighty-four patients were evaluated at a mean follow-up of 37.4 months. The main demographic, surgical, clinical, and radiographic data were recorded. A femoral window for stem removal was performed in 33 patients. Results: Statistically significant improvement was noted for both the Harris Hip score and the Oxford Hip score. Postsurgical complications included thigh pain in three patients, subsidence (>2 mm) in one patient, implant dislocation in two patients, cup revision in one patient, implant revision for septic failure in two patients, and stem revision for varus position in one patient. The stem survivorship rate was 96.3%. There were no significant differences between the groups in which a cortical window was created or not. Conclusion: Femoral stem revision with primary cementless stems is a viable option in selected patients undergoing two-stage hip revision surgery. Correct indication is a cornerstone of good outcome. The use of a cortical window does not affect the final outcome or implant survivorship rate.

Stay Short or Go Long in Revision Total Hip Arthroplasty With Paprosky Type II Femoral Defects: A Comparative Study With the Use of an Uncemented Distal Fixating Modular Stem and a Primary Monobloc Conical Stem With 5-Year Follow-Up

“…Both had initial good fixation, and no fracture or infection was seen at the time of revision. The results for the PCS are also in accordance with other publications [42,45]. In our PCS group, one prosthesis was revised within a year because subsidence of 14 mm due to under sizing.…”

“…In our cohort, 7 two-stage and 22 one-stage revisions were performed. Although we did not find any differences, our evidence is not strong enough to end the discussion if this will influence the outcome [44,45,55,57].…”

Conservative two-stage revision with primary components of infected total hip arthroplasty: An analysis of survival, clinical and radiographic outcomes

“…In their systematic review of the literature, Cavagnaro et al [24,25] highlighted that femoral cementless revision is a feasible option in Paprosky type I and II defects, and reported a survival rate of 95.6% after 4.7 years of follow-up. However, few data on conservative primary acetabular component selection are available in the current literature.…”

The use of a standard-length conical tapered stem in hip revision arthroplasty to address Paprosky type I–II femoral defects: a prospective study of 87 patients

“…Multiple studies previously showed moderate results when using different primary femoral stem designs (cemented and press-fit) in the setting of revision arthroplasty [17,[34][35][36][37][38][39]. Recently, better results have been published showing stem survival rates higher than 90% [7,10,17,18,35,36,40]. These studies provide promising data, but they are limited since they are short-term retrospective studies using either partially or fully coated but tapered single-or double-wedge metaphyseal filling prostheses.…”