Risk factors for subsidence of modular fluted tapered stem implanted by using transfemoral Wagner approach during revisi
- PDF / 435,580 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 55 Downloads / 155 Views
ORIGINAL PAPER
Risk factors for subsidence of modular fluted tapered stem implanted by using transfemoral Wagner approach during revision hip arthroplasty Dino Bobovec 1
&
Ivan Bohaček 2
&
Josip Juras 3
&
Domagoj Delimar 2
Received: 28 March 2020 / Accepted: 18 April 2020 # SICOT aisbl 2020
Abstract Purpose To determine clinical and radiographic risk factors for the vertical subsidence of modular fluted tapered stems implanted using the transfemoral Wagner approach in a cohort of revision hip arthroplasties. Methods A retrospective review of a single-centre surgical registry was performed. Patients who underwent a revision total hip arthroplasty, in which the uncemented modular fluted tapered stem (REVISION Hip/Anca-Ti6Al4V, LimaCorporate, Udine, Italy) was implanted using the transfemoral Wagner approach, were identified. Patient’s demographic data, clinical and radiographic outcomes and post-operative complications were assessed. As a significant subsidence, a 5-mm cut-off was chosen. Results We identified 278 revision hip arthroplasties with a mean follow-up of 35 months. The median of subsidence in the group of 5 mm and less was 2 mm, and 17 mm in the group of subsidence of 5 mm and more. A negative correlation was found between the stem subsidence and the length of good contact between the medial and lateral cortical bone and the stem (medial, − 0.248; P < 0.001, lateral, 0.284; P < 0.001). For 200 mm stems, the percentage of good contact between femoral parts of stem and bone on medial side was 40.5% (81.0 mm) for patients with subsidence of five or less mm, and 30% (60.0 mm) for lateral side. For 140 mm stems, the percentage was 52.86% (74.0 mm) for medial side and 40.36% (56.5 mm) for lateral side. A neck length was shown to correlate significantly with the stem subsidence (P = 0.004). Conclusion It is crucial to provide good contact between the bilateral cortical bone and stem, and, if possible, to select implant constructs with shorter femoral necks, in order to reduce subsidence and to ensure longer implant survivorship. Keywords Hip revision arthroplasty . Subsidence . Risk factors . Bone contact . Transfemoral approach
Introduction Total hip arthroplasty (THA) is a successful treatment for endstage osteoarthritis, but the failure of its components still does occur and represents a devastating complication. The demand for revision hip arthroplasties is projected to increase significantly in the following years, which may be attributed to
* Domagoj Delimar [email protected] 1
Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
2
Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
3
Department of Obstetrics and Gynaecology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
improved implant survivorship, return to higher demand activity in the younger patients and prolonged life expectancy [1]. Nevertheless, the revision burden has remaine
Data Loading...
