Medium-term follow-up of 92 femoral component revisions using a third-generation cementing technique.

Autor: Te Stroet MA; a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands ., Rijnen WH; a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands ., Gardeniers JW; a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands ., Van Kampen A; a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands ., Schreurs BW; a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands .
Jazyk: angličtina
Zdroj: Acta orthopaedica [Acta Orthop] 2016; Vol. 87 (2), pp. 106-12. Date of Electronic Publication: 2015 Nov 16.
DOI: 10.3109/17453674.2015.1115949
Abstrakt: Background and Purpose: Very little has been published on the outcome of femoral cemented revisions using a third-generation cementing technique. We report the medium-term outcome of a consecutive series of patients treated in this way.
Patients and Methods: This study included 92 consecutive cemented femoral revisions performed in our department with a third-generation cementing technique and without instrumented bone impaction grafting between 1996 and 2007. The average age of the patients at revision was 66 (25-92) years. None of the patients were lost to follow-up. At review in December 2013, 55 patients were still alive and had a non-re-revised femoral revision component in situ after a mean follow-up of 11 (5-17) years.
Results: The mean preoperative Harris hip score was 50, and improved to 73 at final follow-up. 2 patients died shortly after the revision surgery. 1 stem was re-revised for aseptic loosening; this was also the only case with radiolucent lines in all 7 Gruen zones. A femoral reoperation was performed in 19 hips during follow-up, and in 14 of these 19 reoperations the femoral component was re-revised. Survivorship at 10 years, with femoral re-revision for any reason as the endpoint, was 86% (95% CI: 77-92). However, excluding 8 patients with reinfections after septic index revisions and 1 with hematogenous spread of infection from the survival analysis, the adjusted survival for re-revision for any reason at 10 years was 92% (95% CI: 83-96). With re-revision for aseptic loosening as endpoint, the survival at 10 years was 99% (CI: 90-100).
Interpretation: Femoral component revision with a third-generation cemented stem results in acceptable survival after medium-term follow-up. We recommend the use of this technique in femoral revisions with limited loss of bone stock.
Databáze: MEDLINE
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