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Published in: International Orthopaedics 5/2012

01-05-2012 | Original Paper

Revision total hip arthroplasty using a cementless tapered revision stem in patients with a mean age of 82 years

Authors: Daniel Neumann, Lothar Dueckelmann, Christoph Thaler, Ulrich Dorn

Published in: International Orthopaedics | Issue 5/2012

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Abstract

Purpose

A tapered straight cementless stem was used for revision in a group of old and very old patients. We wanted to know whether the use of this implant could achieve satisfactory results despite age and osteoporosis.

Methods

We retrospectively analysed data of 77 elderly patients (77 hips) who underwent revision in cemented and uncemented primary total hip arthroplasties (THA). The patients had a mean age of 82.2 years (range, 75–92 years) at revision surgery. They were monitored for a mean follow up of 7.1 years (range, 5.0–10.2 years). During the minimum follow-up period 11 patients died of unrelated causes, leaving 66 patients (66 hips) for evaluation.

Results

During the period of study three stems failed due to aseptic loosening, three hips dislocated and were successfully treated by closed reduction and bracing. No infection, osteolysis or significant stress shielding around the stems was observed. The survivorship at an average of 7.1-year follow-up was 95.5%.

Conclusions

These results indicate that this stem is an excellent alternative in revision THA in patients of 75 years or older.
Literature
1.
go back to reference Korovessis P, Repantis T (2009) High medium-term survival of Zweymüller slr-plus stem used in femoral revision. Clin Orthop Relat Res 467(8):2032–2040PubMedCrossRef Korovessis P, Repantis T (2009) High medium-term survival of Zweymüller slr-plus stem used in femoral revision. Clin Orthop Relat Res 467(8):2032–2040PubMedCrossRef
2.
go back to reference Boehm P, Bischel O (2004) The use of tapered stems for femoral revision surgery. Clin Orthop Relat Res 420:148–159CrossRef Boehm P, Bischel O (2004) The use of tapered stems for femoral revision surgery. Clin Orthop Relat Res 420:148–159CrossRef
3.
go back to reference Chang JD, Kim TY, Rao MB, Lee SS, Kim IS (2011) Revision total hip arthroplasty using a tapered, press-fit cementless revision stem in elderly patients. J Arthroplasty 26(7):1045–1049 Chang JD, Kim TY, Rao MB, Lee SS, Kim IS (2011) Revision total hip arthroplasty using a tapered, press-fit cementless revision stem in elderly patients. J Arthroplasty 26(7):1045–1049
4.
go back to reference Zweymüller K, Steindl M, Melmer T (2005) Anterior windowing of the femur diaphysis for cement removal in revision surgery. Clin Orthop 441:227–236PubMedCrossRef Zweymüller K, Steindl M, Melmer T (2005) Anterior windowing of the femur diaphysis for cement removal in revision surgery. Clin Orthop 441:227–236PubMedCrossRef
5.
go back to reference Zweymüller K (2007) Good results with an uncoated grit-blasted tapered straight stem at ten years. Interact Surg 2:197–205CrossRef Zweymüller K (2007) Good results with an uncoated grit-blasted tapered straight stem at ten years. Interact Surg 2:197–205CrossRef
6.
go back to reference Della Valle CJ, Paprosky WG (2004) The femur in revision total hip arthroplasty evaluation and classification. Clin Orthop Relat Res 420:55–60PubMedCrossRef Della Valle CJ, Paprosky WG (2004) The femur in revision total hip arthroplasty evaluation and classification. Clin Orthop Relat Res 420:55–60PubMedCrossRef
7.
go back to reference D’Aubigne RM, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Jt Surg Am 36:451–475 D’Aubigne RM, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Jt Surg Am 36:451–475
8.
go back to reference Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Jt Surg Am 51:737–755 Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Jt Surg Am 51:737–755
9.
go back to reference Gruen TA, McNeice GM, Amstutz HC (1979) Modes of failure of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27PubMed Gruen TA, McNeice GM, Amstutz HC (1979) Modes of failure of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27PubMed
10.
go back to reference Engh CA, Bobyn JD (1988) The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop Relat Res 231:7–28PubMed Engh CA, Bobyn JD (1988) The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop Relat Res 231:7–28PubMed
11.
go back to reference Gundolf F (2007) Compression cerclage. In: 25 years of biologic fixation, Ed.: Friedrich N, Santore R. Elsevier, Urban+Fischer, Munich Gundolf F (2007) Compression cerclage. In: 25 years of biologic fixation, Ed.: Friedrich N, Santore R. Elsevier, Urban+Fischer, Munich
12.
go back to reference Dohmae Y, Bechtold JE, Sherman RE et al (1988) Reduction in cement-bone interface shear strength between primary and revision arthroplasty. Clin Orthop Relat Res 236:214–220PubMed Dohmae Y, Bechtold JE, Sherman RE et al (1988) Reduction in cement-bone interface shear strength between primary and revision arthroplasty. Clin Orthop Relat Res 236:214–220PubMed
13.
go back to reference Holt G, Hook S, Hubble M (2011) Revision total hip arthroplasty: the femoral side using cemented implants. Int Orthop 35(2):267–273PubMedCrossRef Holt G, Hook S, Hubble M (2011) Revision total hip arthroplasty: the femoral side using cemented implants. Int Orthop 35(2):267–273PubMedCrossRef
14.
go back to reference Paprosky WG, Greidanus NV, Antoniou J (1999) Minimum 10-year-results of extensively porous-coated stems in revision hip arthroplasty. Clin Orthop Relat Res 369:230–242PubMedCrossRef Paprosky WG, Greidanus NV, Antoniou J (1999) Minimum 10-year-results of extensively porous-coated stems in revision hip arthroplasty. Clin Orthop Relat Res 369:230–242PubMedCrossRef
15.
go back to reference Christie MJ, DeBoer DK, Tingstad EM et al (2000) Clinical experience with a modular noncemented femoral component in revision total hip arthroplasty: 4- to 7-year results. J Arthroplast 15:840–846CrossRef Christie MJ, DeBoer DK, Tingstad EM et al (2000) Clinical experience with a modular noncemented femoral component in revision total hip arthroplasty: 4- to 7-year results. J Arthroplast 15:840–846CrossRef
16.
go back to reference Kwong LM, Miller AJ, Lubinus P (2003) A modular distal fixation option for proximal bone loss in revision total hip arthroplasty: a 2- to 6-year follow-up study. J Arthroplast 18:94–98CrossRef Kwong LM, Miller AJ, Lubinus P (2003) A modular distal fixation option for proximal bone loss in revision total hip arthroplasty: a 2- to 6-year follow-up study. J Arthroplast 18:94–98CrossRef
17.
go back to reference Krishnamurthy AB, MacDonald SJ, Paprosky WG (1997) 5- to 13-year follow-up study on cementless femoral components in revision surgery. J Arthroplasty 12:839–844PubMedCrossRef Krishnamurthy AB, MacDonald SJ, Paprosky WG (1997) 5- to 13-year follow-up study on cementless femoral components in revision surgery. J Arthroplasty 12:839–844PubMedCrossRef
18.
go back to reference Weiss RJ, Beckman MO, Enocson A et al (2011) Minimum 5-year follow-up of a cementless, modular, tapered stem in hip revision arthroplasty. J Arthroplast 1:16–23CrossRef Weiss RJ, Beckman MO, Enocson A et al (2011) Minimum 5-year follow-up of a cementless, modular, tapered stem in hip revision arthroplasty. J Arthroplast 1:16–23CrossRef
19.
go back to reference Kolstad K, Adalberth G, Mallmin H et al (1996) The Wagner revision stem for severe osteolysis. 31 hips followed for 1.5–5 years. Acta Orthop Scand 67:541–546PubMedCrossRef Kolstad K, Adalberth G, Mallmin H et al (1996) The Wagner revision stem for severe osteolysis. 31 hips followed for 1.5–5 years. Acta Orthop Scand 67:541–546PubMedCrossRef
20.
go back to reference Weber M, Hempfing A, Orler R et al (2002) Femoral revision using the Wagner stem: results at 2–9 years. Int Orthop 26:36–39PubMedCrossRef Weber M, Hempfing A, Orler R et al (2002) Femoral revision using the Wagner stem: results at 2–9 years. Int Orthop 26:36–39PubMedCrossRef
21.
go back to reference Mertl P, Philippot R, Rosset P, Migaud H, Tabutin J, Van de Velde D (2011) Distal locking stem for revision femoral loosening and periprosthetic fractures. Int Orthop 35(2):275–282PubMedCrossRef Mertl P, Philippot R, Rosset P, Migaud H, Tabutin J, Van de Velde D (2011) Distal locking stem for revision femoral loosening and periprosthetic fractures. Int Orthop 35(2):275–282PubMedCrossRef
22.
go back to reference Parvizi J, Pour AE, Keshavarzi NR, D'Apuzzo M, Sharkey PF, Hozack WJ (2007) Revision total hip arthroplasty in octogenarians. A case-control study. J Bone Jt Surg Am 89(12):2612–2618CrossRef Parvizi J, Pour AE, Keshavarzi NR, D'Apuzzo M, Sharkey PF, Hozack WJ (2007) Revision total hip arthroplasty in octogenarians. A case-control study. J Bone Jt Surg Am 89(12):2612–2618CrossRef
23.
go back to reference Meek RM, Garbuz DS, Masri BA et al (2004) Intraoperative fracture of the femur in revision total hip arthroplasty with a diaphyseal fitting stem. J Bone Jt Surg Am 86A:480–484 Meek RM, Garbuz DS, Masri BA et al (2004) Intraoperative fracture of the femur in revision total hip arthroplasty with a diaphyseal fitting stem. J Bone Jt Surg Am 86A:480–484
24.
go back to reference Lintner F, Huber M, Böhm G, Attems J, Wais R (1996) Der Schneide-Schleif Effekt als wichtiger Parameter zur ossären Einheilung zementfreier Pfannen (German). In: Zweymüller K (ed) 15 Jahre Zweymüller Hüftprothese. Verlag Hans Huber, Bern Lintner F, Huber M, Böhm G, Attems J, Wais R (1996) Der Schneide-Schleif Effekt als wichtiger Parameter zur ossären Einheilung zementfreier Pfannen (German). In: Zweymüller K (ed) 15 Jahre Zweymüller Hüftprothese. Verlag Hans Huber, Bern
Metadata
Title
Revision total hip arthroplasty using a cementless tapered revision stem in patients with a mean age of 82 years
Authors
Daniel Neumann
Lothar Dueckelmann
Christoph Thaler
Ulrich Dorn
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 5/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1379-3

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