Use of short stems in revision of standard femoral stem: A case report.

Autor: Evola FR; University of Catania, Department of Surgery, Clinic Orthopaedic, Catania 95124, Italy. robertoevola@virgilio.it., Evola G; General and Emergency Surgery Department, Surgery Clinic, Catania 95124, Italy., Sessa G; University of Catania, Department of Surgery, Clinic Orthopaedic, Catania 95124, Italy.
Jazyk: angličtina
Zdroj: World journal of orthopedics [World J Orthop] 2020 Nov 18; Vol. 11 (11), pp. 528-533. Date of Electronic Publication: 2020 Nov 18 (Print Publication: 2020).
DOI: 10.5312/wjo.v11.i11.528
Abstrakt: Background: Short stems are usually uncemented prosthetics and are recommended in the treatment of traumatic or degenerative diseases of hip. In revision procedures for elderly patients with serious comorbidity, applying a short stem could reduce peri- and post-operative secondary surgical risks to femoral osteotomy, which are necessary for the removal of parts of the implant or acrylic cement from the medullary canal. There are no cases in the literature that apply a short stem for prosthetic revision by acrylic cement anchorage.
Case Summary: A male patient had a left hip replacement in 1995 due to coxarthrosis. At the age of eighty the patient reported an accidental trauma and walked with pain in the left thigh. The X-ray highlighted the stem breakage in the distal section without fracturing the femoral cortex. The patient had various comorbidities (diabetes, anaemia, heart deficiency, and arrhythmia) presenting a high operation risk (ASA 4). During the revision procedure, the distal apex of the stem could not be removed from the femoral cortex. Because of the poor general health of the patient, the surgeon decided not to perform a Wagner femoral osteotomy to remove the distal section of the stem and decided to implant a short stem to avoid removing the stem section of the previous implant. The patient had his left femur X-rayed 15 d post-trauma.
Conclusion: A field of application of short stem may be the development of a cemented short stem to reduce the complexity of the revision procedure.
Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest and financial relationships for the realization of this work.
(©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze: MEDLINE