Conversion total hip arthroplasty with a proximally modular, distal fixation reconstruction prosthesis following cephalomedullar nail failure
| Autor: | Luis Turus, D. Godoy-Monzon, Francisco Piccaluga, Martin Buttaro, Alberto Cid Casteulani, Fernando Diaz Dilernia |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Arthroplasty Replacement Hip medicine.medical_treatment Distal fixation Bone healing Prosthesis Fracture Fixation medicine Humans Orthopedics and Sports Medicine Femur Aged Retrospective Studies Aged 80 and over Hip fracture Hip Fractures business.industry Middle Aged medicine.disease Stable fixation Prosthesis Failure Surgery Radiography medicine.anatomical_structure Nail (anatomy) Female Hip Prosthesis business Total hip arthroplasty |
| Zdroj: | HIP International. 30:26-33 |
| ISSN: | 1724-6067 1120-7000 |
| DOI: | 10.1177/1120700020937952 |
| Popis: | Background: The goals of intertrochanteric hip fracture (IHF) treatment are stable fixation, early mobilisation and function restoration. If the attempt to reduce, stabilise and fracture healing utilising a femoral cephalomedullar nail (CMN) fails, options for subsequent attempts are limited. Purpose: Evaluate the clinical and radiographic outcomes of conversion total hip arthroplasty (THA) using a modular stem following a CMN failure. Materials and methods: We retrospectively reviewed a consecutive series of patients with an IHF between 2012 and 2014 to identify CMN patients that went on to the subsequent failure and conversion to THA utilising a modular femoral stem (MFS). In all cases, MP Reconstruction Prosthesis (Waldemar Link, Hamburg, Germany) was implanted. Primary clinical outcomes were assessed using Harris Hip Score (HSS) before conversion procedure, 3 months, 6 months and recent office visit post-conversion THA thereafter. The secondary outcome was to analyse intra and postoperative complications. Serial radiographs at each follow-up interval were assessed for clinical success or to confirm adverse events. Results: 28 patients were included in the study; 17 were females. The average age was 72.7 years (SD ± 10.5); the average time from the index procedure to conversion THA was 12.6 months (SD ± 3.5). At baseline, average HHS was 42.1 (SD ± 3.6), improved to 80.7 (SD ± 5.1) at 3 months, 86.0 (SD ± 3.9) at 6-months which levelled off to 86.1 (SD ± 4.0) at final follow-up. There were 4 (14%) post-conversion complications: 2 dislocations, 1 superficial wound infection, 1 patient with symptomatic abductor deficiency. All 4 cases were conservatively treated successfully, the implants were retained, and the patients progressed without further issue. Conclusions: MFSs allow to successfully treat failed CMN and adverse variations in femoral anatomy with a device that will permit simultaneous correction of leg length, offset and version to relieve pain, restore function and create a durable prosthetic to host composite. |
| Databáze: | OpenAIRE |
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