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Short-term results of hip revisions with a curved cementless modular stem in association with the surgical approach

  • Orthopaedic Surgery
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Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

An Erratum to this article was published on 26 November 2008

Abstract

Introduction

A prospective study was designed to test the hypothesis that short-term results after hip revisions are in association with the surgical approach with lower clinical scores for the transfemoral approach.

Materials and methods

A total of 120 hip revision operations with the modular cementless revision stem “Revitan Curved” (Zimmer GmbH, Winterthur, Switzerland), of which 42 replacements involved an endofemoral (posterolateral) approach and 78 implantations a transfemoral approach, were followed up over a period of at least 24 months.

Results

In the early post-operative stage, stems implanted transfemoral were associated with significantly lower Harris Hip Scores and a significantly more frequent appearance of Trendelenburg signs. The differences lessened at the end of the follow-up period. Within the group of transfemoral implantation, all six stems with a circular fixation zone measuring less than 3 cm had subsided and two of these had become loose; none of the stems with greater fixation zones exhibited these properties. In the case of the endofemoral implants, three stems exhibited sinking but there did not appear to be any relationship between this event and length of fixation zone.

Conclusion

The surgical approach has an association with the short-time outcomes of hip revsions using cementless modular stems. Transfemoral implantation of the “Revitan curved” stem requires a fixation zone of at least 3 cm and a longer period of rehabilitation.

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References

  1. Bircher HP, Riede U, Lüem M, Ochsner PE (2001) Der Wert der SL-Revisionsprothese nach Wagner zur Überbrückung großer Femurdefekte. Technik und Resultate. Orthopäde 30:294–303

    Article  PubMed  CAS  Google Scholar 

  2. Böhm P, Bischel O (2001) Femoral revision with the Wagner SL revision stem. J Bone Joint Surg 83-A:1023–1031

    PubMed  Google Scholar 

  3. Böhm P, Bischel O (2001) The uncemented diaphysal fixation of femoral revision stems in case of large bone defects—analysis of twelve years experience with the Wagner SL revision stem. Z Orthop 139:229–239

    Article  PubMed  Google Scholar 

  4. Böhm P, Bischel O (2004) The use of tapered stems for femoral revision surgery. Clin Orthop Rel Res 420:148–159

    Article  Google Scholar 

  5. Challgahan JJ, Slavati EA, Pellicci PM, Wilson PD, Ranawat CS (1985) Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Joint Surg 67-A:1074–1085

    Google Scholar 

  6. Chen WM, McAuley JP, Engh CA Jr, Hopper RH Jr, Engh CA (2000) Extended slide trochanteric osteotomy for revision total hip arthroplasty. J Bone Joint Surg 82-A:1215–1219

    Google Scholar 

  7. Della Valle CJ, Berger RA, Rosenberg AG, Jacobs JJ, Sheinkop MB, Paprosky WG (2003) Extended trochanteric osteotomy in complex primary total hip arthroplasty. A brief note. J Bone Joint Surg 85-A:2385–2390

    PubMed  Google Scholar 

  8. Dohmae Y, Bechthold JE, Sherman RE, Puno RM, Gustilo RB (1988) Reduction in cement-bone interface shear strength between primary and revision arthroplasty. Clin Orthop Relat Res 36:214–220

    Google Scholar 

  9. Duncan DP, Masri BA (1995) Fractures of the femur after hip replacement. Instr Course Lect 44:293–304

    PubMed  CAS  Google Scholar 

  10. Fink B, Hahn M, Fuerst M, Thybaut L, Delling G (2005) Principle of fixation of the cementless modular revision stem Revitan. Unfallchirurg 108:1029–1037

    Article  PubMed  CAS  Google Scholar 

  11. Fink B, Grossmann A (2007) Modified transfemoral approach to revision arthroplasty with uncemented modular revision stems. Oper Orthop Traumatol 19:32–55

    Article  PubMed  Google Scholar 

  12. Fink B, Grossmann A, Schubring S, Schulz MS, Fuerst M (2007) A modified transfemoral approach using modular cementless revision stems. Clin Orthop Relat Res 462:105–114

    Article  PubMed  Google Scholar 

  13. Glassman AH (2004) Exposure for revision total hip replacement. Clin Orthop Relat Res 420:39–47

    Article  PubMed  Google Scholar 

  14. Grünig R, Morscher E, Ochsner PE (1997) Three- to 7-year results with the uncemented SL femoral revision prosthesis. Arch Orthop Trauma Surg 116:187–197

    Article  PubMed  Google Scholar 

  15. Gustilo RB, Pasternak HS (1988) Revision total hip arthroplasty with titanium ingrowth prosthesis and bone grafting for failed cemented femoral component loosening. Clin Orthop Relat Res 235:111–119

    PubMed  Google Scholar 

  16. Hartwig C-H, Böhm P, Czecg U, Reize P, Küsswetter W (1996) The Wagner revision stem in alloarthroplasty of the hip. Arch Orthop Trauma Surg 115:5–9

    Article  PubMed  CAS  Google Scholar 

  17. Hedley AD, Gruen TA, Ruoff OP (1988) Revision of failed total hip arthroplasties with uncemented porous-coated anatomic components. Clin Orthop Relat Res 235:75–90

    PubMed  Google Scholar 

  18. Huffman GR, Ries MD (2003) Combined vertical and horizontal cable fixation of an extended trochanteric osteotomy site. J Bone Joint Surg 85-A:273–277

    PubMed  Google Scholar 

  19. Isacson J, Stark A, Wallensten R (2000) The Wagner revision prosthesis consistently restores femoral bone structure. Int Orthop 24:139–142

    Article  PubMed  CAS  Google Scholar 

  20. Kolstad K, Adalberth G, Mallmin H, Milbrink J, Sahlsted B (1996) The Wagner revision stem for severe osteolysis. 31 hips followed for 1.5–5 years. Acta Orthop Scand 67:541–544

    Article  PubMed  CAS  Google Scholar 

  21. Krishnamurthy AB, MacDonald SJ, Paprosky WG (1997) 5- to 13-year follow-up study on cementless femoral components in revisions surgery. J Arthroplasty 12:839–847

    Article  PubMed  CAS  Google Scholar 

  22. Le Béguec P (2000) Système PFM-revision pour reprise d’une prothèse fémorale descellée. Maîtrise orthopédique 91

  23. Mardones R, Gonzalez C, Cabanela ME, Trousdale RT, Berry DJ (2005) Extended femoral osteotomy for revision of hip arthroplasty: results and complications. J Arthroplasty 20:79–83

    Article  PubMed  Google Scholar 

  24. Miner TM, Momberger NG, Chong D, Paprosky WL (2001) The extended trochanteric osteotomy in revision hip arthroplasty: a critical review of 166 cases at mean 3-year, 9-month follow-up. J Arthroplasty 16:188–194

    Article  PubMed  CAS  Google Scholar 

  25. Moreland JR, Bernstein ML (1995) Femoral revison hip arthroplasty with uncemented, porous-coated stems. Clin Orthop Rel Res 319:141–150

    Google Scholar 

  26. Paprosky WG, Lawrence J, Cameron H (1990) Femoral defect classification. Clinical application. Orthop Rev 19(Suppl):9–15

    Google Scholar 

  27. Paprosky WG, Greidanus NV, Antoniou J (1999) Minimum 10-year results of extensively porous-coated stems in revision hip arthroplasty. Clin Orthop Relat Res 369:230–242

    Article  PubMed  Google Scholar 

  28. Paprosky WG, Weeden SH, Bowling JW Jr (2001) Component removal in revision total hip arthroplasty. Clin Orthop Relat Res 393:181–193

    Article  PubMed  Google Scholar 

  29. Peters PC Jr, Head WC, Emerson RH Jr (1993) An extended trochanteric osteotomy for revision total hip replacement. J Bone Joint Surg 75-Br:158–159

    Google Scholar 

  30. Sieber HP, Le Bèguec P (2001) Einsatz des PFM-R-Schaftes bei Revisionseingriffen. In: Perka C, Zippel H (eds) Revisionsendoprothetik des Hüftgelenkes. Schaftrekonstruktion und perioperatives Management. Einhorn-Presse Verlag, pp 174–184

  31. Wagner H (1987) Revisionsprothese für das Hüftgelenk bei schwerem Knochenverlust. Orthopäde 16:295–300

    PubMed  CAS  Google Scholar 

  32. Wagner H (1989) Revisionsprothese für das Hüftgelenk. Orthopäde 18:438–453

    PubMed  CAS  Google Scholar 

  33. Wagner H, Wagner M (1993) Femur-Revisionsprothese. Z Orthop 131:574–577

    Article  PubMed  CAS  Google Scholar 

  34. Wagner H, Wagner M (1997) Hüftprothesenwechsel mit der Femur-Revisionsprothese. Erfahrungen von 10 Jahren. Med Orthop Tech 117:138–148

    Google Scholar 

  35. Warren PJ, Thompson P, Flechter MDA (2002) Transfemoral implantation of the Wagner SL stem. The abolition of subsidence and enhancement of osteotomy union rate using Dall-Miles cables. Arch Orthop Trauma Surg 122:557–560

    PubMed  CAS  Google Scholar 

  36. Weber M, Hempfing A, Orler R (2002) Femoral revision using the Wagener stem: results at 2–9 years. Int Orthop 26:36–39

    Article  PubMed  CAS  Google Scholar 

  37. Weeden SH, Paprosky WG (2002) Minimal 11-year follow-up of extensively porous-coated stems in femoral revision total hip arthroplasty. J Arthroplasty 17(4 Suppl 1):134–137

    Article  PubMed  Google Scholar 

  38. Wilkes RA, Birch J, Pearse MF, Lee M, Atkins RM (1994) The Wagner technique for revision arthroplasty of the hip: a review of 24 cases. J Orthop Rheum 7:196–198

    Google Scholar 

  39. Wirtz DC, Niethard FU (1997) Ursachen, Diagnostik und Therapie der aseptischen Hüftendoprothesenlockerung—eine Standortbestimmung. Z Orthop 135:270–280

    PubMed  CAS  Google Scholar 

  40. Younger TI, Bradford MS, Magnus RE, Paprosky WG (1995) Extended proximal femoral osteotomy. A new technique for femoral revision arthroplasty. J Arthroplasty 10:329–338

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Clinic of Joint Replacement, General and Rheumatic Orthopaedics, Orthopaedic Clinic Markgröningen gGmbH, Kurt-Lindemann-Weg 10, 71706, Markgröningen, Germany

    Bernd Fink, Alexandra Grossmann & Martin S. Schulz

  2. Orthopaedic Department of Rheumaklinik Bad Bramstedt, Oskar-Alexander-Str. 26, 24576, Bad Bramstedt, Germany

    Svenja Schubring & Martin Fuerst

Authors
  1. Bernd Fink
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  2. Alexandra Grossmann
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  3. Svenja Schubring
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  4. Martin S. Schulz
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  5. Martin Fuerst
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Correspondence to Bernd Fink.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00402-008-0785-5.

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Fink, B., Grossmann, A., Schubring, S. et al. Short-term results of hip revisions with a curved cementless modular stem in association with the surgical approach. Arch Orthop Trauma Surg 129, 65–73 (2009). https://doi.org/10.1007/s00402-008-0617-7

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