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Satisfactory clinical and radiographic outcomes following revision total hip arthroplasty by direct anterior approach using primary femoral stems at 2–8 years of follow-up

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

To report clinical and radiographic outcomes of revision total hip arthroplasty (THA) through the direct anterior approach (DAA) using primary stems.

Materials and methods

The authors assessed a consecutive series of revision THAs operated by DAA using primary (cemented and uncemented) stems between 1/1/2010 and 30/06/2017. The initial cohort comprised 47 patients (50 hips), aged 65 ± 10 years with BMI of 25 ± 4 kg/m2. Clinical assessment included modified Harris Hip Score (mHHS) and satisfaction with surgery. Radiographic assessment included radiolucent lines > 2 mm, bone remodelling, cortical hypertrophy, pedestal formation, and osteolysis. Linear regression analyses were performed.

Results

Of the 50 hips (47 patients) in the initial cohort, intraoperative complications that did not require re-revision occurred in 5 hips. At a follow-up of > 2 years: 5 hips (10%) were lost to follow-up and 3 hips (6%) required stem re-revision, leaving a final cohort of 42 hips (40 patients). Postoperative complications that did not require re-revision occurred in 4 hips (8%). At 4.3 ± 1.6 years, post-revision mHHS was 89 ± 14 (range 47–100) and 38 patients were satisfied or very satisfied with revision surgery. Bone remodelling was observed in 8 hips (16%), cortical hypertrophy in 6 hips (12%), grade I heterotopic ossification in 7 hips (14%), and grade II in 1 hip (2%). There were no cases of radiolucent lines, pedestal formation, or osteolysis. Regression analyses revealed that post-revision mHHS was not associated with any variable.

Conclusions

Revision THA performed through the DAA using primary stems grants satisfactory clinical and radiographic outcomes at a minimum follow-up of two years.

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Data availability

Data can be requested from the corresponding author.

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Funding

This work was supported by ‘GCS Ramsay Santé pour l’Enseignement et la Recherche’, which provided funding for manuscript preparation and statistical analyses. GCS Ramsay Santé pour l’Enseignement et la Recherche, COS-RGDS-2019-12-003-LAUDE-F, Frederic Laude.

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Authors and Affiliations

  1. Clinique du Sport, Ramsay Santé, 36 Boulevard Saint-Marcel, 75005, Paris, France

    Maria-Roxana Viamont-Guerra & Frederic Laude

  2. Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Morumbi, São Paulo, SP, 05652-000, Brazil

    Maria-Roxana Viamont-Guerra

  3. ReSurg SA, Rue Saint-Jean 22, 1260, Nyon, Switzerland

    Sonia Ramos-Pascual & Mo Saffarini

Authors
  1. Maria-Roxana Viamont-Guerra
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  2. Sonia Ramos-Pascual
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  3. Mo Saffarini
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  4. Frederic Laude
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Corresponding author

Correspondence to Mo Saffarini.

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Conflict of interest

MRVG, SRP, and MS have nothing to declare. FL declares royalties from Medacta.

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The present work was completed after being approved by an institutional review board (IRB: COS-RGDS-2019-12-003-LAUDE-F).

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Viamont-Guerra, MR., Ramos-Pascual, S., Saffarini, M. et al. Satisfactory clinical and radiographic outcomes following revision total hip arthroplasty by direct anterior approach using primary femoral stems at 2–8 years of follow-up. Arch Orthop Trauma Surg 143, 6393–6402 (2023). https://doi.org/10.1007/s00402-023-04838-6

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