The Survival of Well-Fixed Cementless Femoral Component After Isolated Acetabular Component Revision
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ORIGINAL ARTICLE
The Survival of Well‑Fixed Cementless Femoral Component After Isolated Acetabular Component Revision Mehmet Ekinci1 · Yucel Bilgin1 · Yasin Sayar1 · Omer Naci Ergin1 · Ahmet Salduz1 · Turgut Akgul1 · Irfan Ozturk1 Received: 4 April 2020 / Accepted: 19 May 2020 / Published online: 30 May 2020 © Indian Orthopaedics Association 2020
Abstract Background It remains controversial whether isolated acetabular component revision or both component revision surgeries should be performed in patients with stable femoral component. The present study aimed to evaluate the survival of patients with unrevised stable uncemented femoral stem who underwent isolated acetabular component revision. Material and Methods A retrospective analysis was conducted in patients who underwent isolated acetabular component revision and had stable uncemented femoral component during revision hip arthroplasty between February 1998 and December 2009. Demographic data of the patients included age, previous surgery, complications, duration between primary and revision surgery, and duration between revision and latest follow-up. Functional results were analyzed using Harris Hip Score (HHS). Results Fifteen hips of thirteen patients were included in the study with a mean age of 62.08 ± 12.9 years. Average time from THA to the isolated acetabular revision was 9.2 ± 3.48 years. Average follow-up time from revision to the latest follow-up was 12.39 ± 2.68 years, and femoral components had been followed for an average of 21.6 ± 4.06 years since the time of implantation. Average HHS of the patients were 53 before revision surgery and 81.9 at the last follow-up (p 5 mm indicating femoral component loosening and re-revision THA. Bone defects on the acetabulum were classified according to the
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Paprosky [10] classification based on the the radiographic evaluation and perioperative findings. Preoperative pelvis and hip radiographs were evaluated to identify any perifemoral radiolucencies according to Gruen et al. [11] and periacetabular radiolucencies according to the system of Delee and Charnley [12]. All primary uncemented femoral components showed evidence of osseointegration and were judged to be stable prior to revision surgery based on the radiographic criteria described by Engh et al. [13]. Osteolysis was defined as a radiographic appearance of any focal bone resorption area > 1 mm in width that was not apparent on the radiograph obtained immediately after surgery [14]. The radiological criteria for loosening were as follows: positional change in the component, > 2 mm of radiolucency around the acetabular component, or an increase in the radiolucent area. Additionally, stabilities of the femoral components were evaluated with longitudinal traction and rotational forces during the acetabular cup revision. Serum C-reactive protein (CRP), white blood cell count, percentage of polymorphonuclear leukocyte, erythrocyte sedimentation rate were investigated to rule out infection preoperatively. Intraoperative findings to rule o
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