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Impaction bone grafting for femoral revision hip arthroplasty with Exeter Universal stem in Japan

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

Abstract

Objectives

The purpose of the present study was to analyze the retrospective clinical and radiographic results of femoral revision arthroplasties with impaction bone grafting performed by experienced Japanese surgeons.

Patients and methods

We investigated the radiographic and clinical records more than 2 years after the surgery in 99 hips of 93 patients. The average age was 66.3 years (36–84 years) and the average follow-up period was 5.2 years (2–13 years). The Merle d’Aubigné and Postel hip score was used for clinical assessment, and peri-operative fractures were recorded. The survival curve was estimated using Kaplan–Meier method.

Results

The mean Merle d’Aubigné and Postel hip score improved from 9.0 points to 15.2 points at the final follow-up. Augmentations for segmental defect of femoral cortices were undertaken in 55 hips. Metal or strut allograft plates were applied to 9 hips and 21 hips, respectively. Intra-operative fractures or perforations occurred in 20 hips. Re-operations of the femur were undertaken in nine hips including five post-operative femoral fractures. More than 5 mm of subsidence was observed in only 2 hips. The survival rates at 8 years after the operation were 94.8 % with femoral fractures as the end point, 93.1 % with any stem removal or exchange as the end point, and 99.0 % with aseptic stem loosening as the end point, respectively.

Conclusion

The present study showed encouraging mid-term results of impaction bone grafting for femoral revision arthroplasty by experienced surgeons in Japan. Aggressive augmentation of segmental defects and attenuated femoral shafts prevents massive stem subsidence and periprosthetic fracture.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Hamamatsu Medical Center, 328 Tomitsuka-cho, Naka-ku, Hamamatsu, Shizuoka, 432-8580, Japan

    Toshiki Iwase

  2. Department of Orthopedic Surgery, School of Medicine, Aichi Medical University, Aichi, Japan

    Hiromi Otsuka

  3. Department of Orthopedic Surgery, Hokkaido Orthopedic Memorial Hospital, Sapporo, Japan

    Naoyuki Katayama

  4. Department of Orthopedic Surgery, Kyoto Katsura Hospital, Kyoto, Japan

    Hiroshi Fujita

Authors
  1. Toshiki Iwase
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  2. Hiromi Otsuka
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  3. Naoyuki Katayama
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  4. Hiroshi Fujita
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Correspondence to Toshiki Iwase.

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Iwase, T., Otsuka, H., Katayama, N. et al. Impaction bone grafting for femoral revision hip arthroplasty with Exeter Universal stem in Japan. Arch Orthop Trauma Surg 132, 1487–1494 (2012). https://doi.org/10.1007/s00402-012-1561-0

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  • DOI: https://doi.org/10.1007/s00402-012-1561-0

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