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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-11-2018 | Hip Arthroplasty

Long-term results of revision total hip arthroplasty with a cemented femoral component

Authors: Armin Pallaver, Lukas Zwicky, Lilianna Bolliger, Hans Bösebeck, Isabella Manzoni, Sabine Schädelin, Peter E. Ochsner, Martin Clauss

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2018

Abstract

Introduction

In revision total hip arthroplasty (THA), the cancellous bone is normally completely removed out of the femoral canal during stem extraction. This situation is comparable to primary THA following the shape-closed concept, with some authors advocating to remove the metaphyseal cancellous bone to enhance press-fit stability (“French paradox”). The aim of this study was to investigate the long-term outcome, regarding survival and radiological results, of a cemented straight stem when used for revision THA and to compare these results to the results of the same stem in primary THA.

Materials and methods

178 stem revisions performed between 01/1994 and 08/2008 using the Virtec straight stem were included. The cumulative incidence for re-revision was calculated using a competing risk model. Risk factors for re-revision of the stem were analyzed using an absolute risk regression model. Radiographs analyzed for osteolysis, debonding and subsidence had a minimum follow-up of 10 years.

Results

The cumulative incidence for re-revision due to aseptic loosening of the stem was 5.5% (95% CI, 2.9–10.2%) at 10 years. Aseptic loosening was associated with younger age, larger defect size and larger stem size. After a minimum 10-year follow-up, osteolysis was seen in 39 of 80 revision THA. Compared to the results in primary THA, the survival in revision THA with the same implant was inferior.

Conclusions

Cemented straight stems used for revision THA showed excellent long-term results regarding survivorship and radiological outcome. This stem therefore offers a valuable and cost-effective option in revision THA.

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Title: Long-term results of revision total hip arthroplasty with a cemented femoral component
Authors: Armin Pallaver
Lukas Zwicky
Lilianna Bolliger
Hans Bösebeck
Isabella Manzoni
Sabine Schädelin
Peter E. Ochsner
Martin Clauss
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-3023-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Long-term results of revision total hip arthroplasty with a cemented femoral component

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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