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Technical modifications for the Wagner SL hip arthroplasty. Short oblique osteotomy of the proximal 1/3 of the femur

  • Ph. Vichard
  • E. Gagneux
  • P. Garbuio
Technical note
  • 164 Downloads

Summary

58 Wagner prostheses were implanted between 1989 and 1996. This was done through a simplified technique without trochanteric osteotomy or grafting. The Wagner transfemoral approach was only used once. The other operations were done through the Moore approach. Classical windows were not used since we feel they give a poor view and predispose to later fractures. We distinguished between the simple cases using the intra-medullary route with image intensifier control, and the difficult cases where the short oblique subtrochanteric osteotomy was used. This manouvre was the simplest way of removing the cement and the prosthesis and of inserting a Wagner prosthesis of 265 mm or longer which also requires a diaphyseal osteotomy to prevent cortical splitting. The Wagner transfemoral route is only needed for removal of uncemented prostheses. Infection is a good indication for this technique where a one stage revision is planned. This technique, like the pure intra-medullary route is derived from the principles of closed intra-medullary nailing.

Key words

Hip arthroplasty Wagner prosthesis 

References

  1. 1.
    Hartmann D (1995) La prothèse fémorale de reprise SL de Heinz Wagner. A propos de 42 cas. Thesis, BesançonGoogle Scholar
  2. 2.
    Lamy H (1993) Reprises des descellements fémoraux de prothèses totales de hanche par prothèses non cimentées de Lord et de Wagner. Thesis, StrasbourgGoogle Scholar
  3. 3.
    Sanders R, Kenneth JK, Thomas DP (1993) Exposure of the orthopedic surgeon to radiation. J Bone Joint Surg [Am] 75: 326–330Google Scholar
  4. 4.
    Schenk RK, Wehrli U (1989) Zur Reaktion des Knochens auf eine Zementfreie sl-Femur-revisionsprothese. Histologische Befunde an einem fänfeinhalb Monate postoperationem gewonnenen Autopsiepräparat. Orthopäde 18: 454–462PubMedGoogle Scholar
  5. 5.
    Vichard Ph, Brientini JM, Elias BE (1992) L'extraction du ciment périprothétique fémoral. Intérêt de la voie endomédullaire pure. Rev Chir Orthop 78 [Suppl 1]: 212Google Scholar
  6. 6.
    Vives P (1989) Descellement aseptique des prothèses totales de hanche repris par prothèse cimentée. Symposium. Directeur P. Vives. SOFCOT, 38e réunion annuelle, novembre 1968. Rev Chir Orthop 75 [Suppl 1]: 23–60Google Scholar
  7. 7.
    Wagner H (1989) Prothèse de révision de l'articulation coxo-fémorale. Orthopäde 18: 438–453PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • Ph. Vichard
    • 1
  • E. Gagneux
    • 1
  • P. Garbuio
    • 1
  1. 1.Service de Chirurgie Orthopédique, Traumatologique et Plastique (Pr Vichard)CHU, Hôpital Jean-MinjozBesançon cedexFrance

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