Results of hydroxyapatite ceramic coated primary femoral stem in revision total hip replacement
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ORIGINAL PAPER
Results of hydroxyapatite ceramic coated primary femoral stem in revision total hip replacement Ahmed Barakat 1
&
Jonathan Quayle 1 & Philip Stott 1 & James Gibbs 1 & Mark Edmondson 1
Received: 26 March 2020 / Accepted: 17 April 2020 # SICOT aisbl 2020
Abstract Purpose The purpose of this study was to assess survival rate, functional and radiological outcomes when using a hydroxyapatite-ceramic fully coated primary femoral stem in revision total hip arthroplasty. Methods Patients who underwent revision total hip arthroplasty using the Furlong hydroxyapatite-ceramic (HAC)-coated (Joint Replacement Instrumentation Ltd., Sheffield, UK) primary stem were retrospectively identified between 2013 and 2017. A total of 30 hips in 27 patients were identified and the mean follow-up duration was 44 months. Post-operative radiographs were scrutinized for signs of component loosening by two independent assessors. Patient’s functional outcomes were assessed using the Oxford hip score and compared pre- and post-operatively. The prevalence of thigh pain was assessed at the latest follow-up. Results The most common cause of revision was adverse reactions to metal debris (ARMD) (46.6%). The overall complication rate was 13.3%. Results at final follow-up demonstrated 100% survival rate and no reported incidence of thigh pain. Using paired t test, all patients had a statistically significant (P < 0.05) improvement in post-operative mean Oxford hip score of 35 compared to a mean pre-operative score of 14. Radiographic analysis of the latest follow-up radiographs revealed no signs of component loosening or component subsidence. Conclusion With a 100% survival rate and excellent reported functional outcomes, we believe that our experience and results support the use of primary cementless stems in selected revision cases. Keywords Revision total hip arthroplasty . Pseudotumors . Furlong stem . Primary stems
Introduction Alongside the expansion of the elderly population and increased life expectancy, there is an associated growth in the numbers of total hip arthroplasty (THA) and their subsequent
* Ahmed Barakat [email protected] Jonathan Quayle [email protected] Philip Stott [email protected] James Gibbs [email protected] Mark Edmondson [email protected] 1
Princess Royal Hospital, Lewes Road, Haywards Heath, England
revisions. modular revision femoral stems are currently the work horse for revision THA (rTHA) owing to their modularity and ability to compensate for the femoral bone loss that is often encountered during revision surgery [14]. However, cost, complexity, intra-operative fractures, failure at the modular interface, thigh pain with long stems, and diminished available bone stock are all recognized complications of these stems [2]. The use of femoral stem prothesis intended for use in primary THA (referred to as primary stems) in selected revision cases is tempting for several reasons. Firstly, shorter stems preserve bone stock. Secondly, it may simplify further revisions as
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