Cement-in-cement revision of the femoral stem: analysis of 1179 first-time revisions in the Swedish Hip Arthroplasty Register
| Autor: | Ola Rolfson, Johan Kärrholm, Maziar Mohaddes, Peter Cnudde, A. J. Timperley |
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| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
Male Reoperation medicine.medical_specialty Arthroplasty Replacement Hip Kaplan-Meier Estimate Femoral stem Prosthesis Design 03 medical and health sciences 0302 clinical medicine Cement mantle Medicine Humans Orthopedics and Sports Medicine Femur 030212 general & internal medicine Registries Femoral component Cementation Revision hip arthroplasty Device Removal Aged Cement Aged 80 and over Sweden 030222 orthopedics business.industry Bone Cements Middle Aged Surgery Prosthesis Failure Hip arthroplasty Treatment Outcome Female Hip Prosthesis business Total hip arthroplasty Follow-Up Studies |
| Zdroj: | The bonejoint journal. (4 Supple) |
| ISSN: | 2049-4408 |
| Popis: | Aims Compared with primary total hip arthroplasty (THA), revision surgery can be challenging. The cement-in-cement femoral revision technique involves removing a femoral component from a well-fixed femoral cement mantle and cementing a new stem into the original mantle. This technique is widely used and when carried out for the correct indications, is fast, relatively inexpensive and carries a reduced short-term risk for the patient compared with the alternative of removing well-fixed cement. We report the outcomes of this procedure when two commonly used femoral stems are used. Patients and Methods We identified 1179 cement-in-cement stem revisions involving an Exeter or a Lubinus stem reported to the Swedish Hip Arthroplasty Register (SHAR) between January 1999 and December 2015. Kaplan-Meier survival analysis was performed. Results Survivorship is reported up to six years and was better in the Exeter group (91% standard deviation (sd) 2.8% versus 85% sd 5.0%) (p = 0.02). There was, however, no significant difference in the survival of the stem and risk of re-revision for any reason (p = 0.58) and for aseptic loosening (p = 0.97), between revisions in which the Exeter stem (94% sd 2.2%; 98% sd 1.6%) was used compared with those in which the Lubinus stem (95% sd 3.2%; 98% sd 2.2%) was used. The database did not allow identification of whether a further revision was indicated for loosening of the acetabular or femoral component or both. Conclusion The cement-in-cement technique for revision of the femoral component gave promising results using both designs of stem, six years post-operatively. Cite this article: Bone Joint J 2017;99-B(4 Supple B):27–32. |
| Databáze: | OpenAIRE |
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