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KMID : 0386720030150020150
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Journal of the Korean Hip Society
2003 Volume.15 No. 2 p.150 ~ p.157
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Revision Hip Arthroplasty with Extensively Porous-Coated Femoral Stem
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Min Byung-Woo
Song Kwang-Soon
Kang Chul-Hyung
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Abstract
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Purpose: To report the outcomes of extensively porous-coated femoral stems based on diaphyseal fixation due to extensive bone loss and osteoporosis of the proximal femur in revision total hip arthroplasty.
Materials and Methods: Eighteen cementless femoral revision surgeries, with extensively porous-coated stems, performed between 1997 and 2000, were retrospectively reviewed. The follow ups ranged from 2 to 5.4 years, with an average of 3 years. The average age at surgery was 54.4 years. The reasons for the revisions were aseptic loosening in 12 hips, periprosthetic fracture in 3, progressive osteolysis in 2 and septic loosening in 1.
Results: 3 patients had minimal thigh pain. Radiographical evidence of a bone ingrown stem was present in 95% of the hips. 5% of the hips were stable fibrous fixations. Stem subsidence of more than 5mm was noticed in one hip, but without further progression after 1 year. Moderate stress-shielding was noticed in one hip. To date, no significant wear or osteolysis has been observed.
Conclusion: An extensively porous-coated revision stem seems to be a reasonable choice in the presence of proximal femoral bone loss. However, the concerns relating to the incidences of thigh pain, stress shielding, and difficulties in re-revisions, will require a longer term follow up.
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KEYWORD
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Total hip replacement, Revision, Extensively porous-coated femoral stem
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