Revisión femoral con tallo cónico de fijación distal. [Femoral revision with conical stem of distal fixation.]

Autor: Javier Eduardo Nuñez, Jose Miguel Gomez, Martín Mangupli, Leandro Ariel Salcedo Zunino, Ignacio Pioli, Bartolomé Luis Allende
Rok vydání: 2017
Předmět:
Zdroj: Revista de la Asociación Argentina de Ortopedia y Traumatología. 82:40
ISSN: 1852-7434
1515-1786
DOI: 10.15417/632
Popis: BackgroundProximal bone loss at the femoral stem is the main challenge facing surgeons at the time of revision total hip arthroplasty. The aim of revision surgeries to obtain a stable placement of components and to restore joint kinematics. ObjectivesThe purpose of this paper is to present our experience in hip revisions with tapered distal stem fixation with a minimum follow-up of 2 years. Evaluate the survival of the implants used, Harris hip score, complications and reinterventions associated with the use of these stems for complex femoral revision surgeries.Study Design & MethodsSeries of Cases. We evaluated 37 patients (39 hips) between 2010 and 2014 in which non-cemented femoral stems were used (28 modular and 11 non-modular).The average age was 63.5 years (SD 13.3). Study patients included 18 (48.64%) women and 19 (51.35%) men. Causes of reoperation included 14 (35.89%) cases of aseptic loosening, 14 (35.89%) infections, 7 (17.94%) periprosthetic fractures, 3 (7.69%) stem fracture and 1 (2.56%) for instability. Mean follow-up was 42 months (range, 24-74 months).ResultsThe survival of the femoral stem for any reason according to Kaplan-Meier's analysis was 92.3%. The average Harris score improved from 37 (10-77) points before the operation to 81 points (33-96) at last follow-up. Four patients (10,2 %) presented dislocation; one (2,5 %) deep infection; one (2,5 %) had an intra-operative fracture; subsidence took place in 3 (7,6 %) patients and it was necessary to reurse 2 (5,1 %) femoral implants.ConclusionsThe femoral stem has showed satisfactory results in 2 to 6 years of follow-up in several conditions of femoral revision surgeries. It requires a simple technique with clinical improvement that has been widely published in the literature.
Databáze: OpenAIRE