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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 2/2011

01-02-2011 | Symposium: Papers Presented at the Hip Society Meetings 2010

Modular Femoral Stems for Revision Total Hip Arthroplasty

Authors: Camilo Restrepo, MD, Magdalena Mashadi, MD, Javad Parvizi, MD, FRCS, Matthew S. Austin, MD, William J. Hozack, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2011

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Abstract

Background

Modular femoral stems are one option for revision THA surgeons and allow offset restoration, leg length discrepancy correction, and stability independent of distal stem fixation. The complexity of revision THA usually leads surgeons to use multiple revision hip designs to address these issues.

Questions/purposes

We evaluated functional outcomes with a revision modular system and determined whether such a system achieved initial distal fixation, femoral offset restoration, leg length equalization, and hip stability.

Methods

We prospectively followed 118 patients in whom a modular stem system was used for reconstruction of their failed index femoral stem. Sixty-nine hips were classified as Type I (classification of Paprosky et al.), 35 as Type II, 17 as Type III, and one as Type IV. Functional assessment was achieved using patient- and physician-administered outcome evaluations (SF-36, WOMAC, Lower Extremity Activity Scale, Harris hip score). Stem fixation, offset restoration, leg length discrepancy, and hip stability were evaluated radiographically. Complications were also recorded. Minimum followup was 2 years (average, 4 years; range, 2–7 years).

Results

Average values on all functional outcome evaluations showed improvement at latest followup. Distal bone ingrowth fixation was obtained in 100% of the patients, offset was corrected in 66%, leg length discrepancy was corrected in 78%, and stability was achieved in 97%. No failures or fractures at the body to stem junction were seen at latest followup.

Conclusions

Modular femoral components achieved functional outcomes and were useful to address distal fixation, femoral offset restoration, leg length equalization, and hip stability when revising failed femoral components.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Modular Femoral Stems for Revision Total Hip Arthroplasty
Authors
Camilo Restrepo, MD
Magdalena Mashadi, MD
Javad Parvizi, MD, FRCS
Matthew S. Austin, MD
William J. Hozack, MD
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1561-8

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