In the case of extensively damaged meta-diaphyseal femoral bone with cortices thinning and widened femoral canal, tapered stems allow a good primary fixation and early weight-bearing. A retrospective review was conducted to evaluate long-term results of modular revision taper stems implanted from March 1999 to December 2002. Sixty-five consecutive hip revision surgeries were performed, mostly for aseptic loosening (75\% of the cases). Femoral bone stock defects were classified according to AAOS's criteria and consisted mainly in type II (cavitary defects, 44.6\%) and type III (combined defects, 33.9\%). A trochanteric osteotomy was performed in 25 cases (38\%) to remove primary implants that were cemented in 35 cases (54\%). The mean postoperative follow-up was 109 months (range, 76 to 131 months). Clinical assessment at follow-up showed a significantly improved mean Harris Hip Score from 42 points preoperatively to 81 points postoperatively, while the x-ray examination did show a satisfactory distal integration of the stem in all cases and satisfactory reconstitution of the femoral bone stock in 47\% of cases. The average subsidence of the stem at follow-up was less than one millimeter. According to data analysis, a leg-length discrepancy exceeding 15 millimeters caused significantly worse functional outcome and pain.

Femoral Revision with Taper Stems: Results at Ten Years Follow-up.

CHERUBINO, PAOLO;D'ANGELO, FABIO;SURACE, MICHELE FRANCESCO
2010-01-01

Abstract

In the case of extensively damaged meta-diaphyseal femoral bone with cortices thinning and widened femoral canal, tapered stems allow a good primary fixation and early weight-bearing. A retrospective review was conducted to evaluate long-term results of modular revision taper stems implanted from March 1999 to December 2002. Sixty-five consecutive hip revision surgeries were performed, mostly for aseptic loosening (75\% of the cases). Femoral bone stock defects were classified according to AAOS's criteria and consisted mainly in type II (cavitary defects, 44.6\%) and type III (combined defects, 33.9\%). A trochanteric osteotomy was performed in 25 cases (38\%) to remove primary implants that were cemented in 35 cases (54\%). The mean postoperative follow-up was 109 months (range, 76 to 131 months). Clinical assessment at follow-up showed a significantly improved mean Harris Hip Score from 42 points preoperatively to 81 points postoperatively, while the x-ray examination did show a satisfactory distal integration of the stem in all cases and satisfactory reconstitution of the femoral bone stock in 47\% of cases. The average subsidence of the stem at follow-up was less than one millimeter. According to data analysis, a leg-length discrepancy exceeding 15 millimeters caused significantly worse functional outcome and pain.
2010
Cherubino, Paolo; A., Fagetti; D'Angelo, Fabio; Surace, MICHELE FRANCESCO
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/1761702
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