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KMID : 1028220120240020087
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Hip & Pelvis
2012 Volume.24 No. 2 p.87 ~ p.93
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Risk Factors Related to Modular Femoral Stem Failures in Revision Hip Arthroplasty
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Park Jong-Hyuk
Park Myung-Sik
Kim Do-Yeon
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Abstract
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Purpose: The purpose of this study was to analyze failure rates and causes of hip arthroplasty revisions associated with the use of cementless modular femoral stems.
Materials and Methods: This study comprised 93 patients(100 hips) that were followed up for more than two years after revision involving modular femoral stem arthroplasty. The clinical results were evaluated using the Harris Hip Score and the radiologic results were evaluated using leg length discrepancy, subsidence and bone formation assessments. We analyzed the relationship between the number of hip surgeries performed and the bone deficiencies and failures observed. Preoperative femoral bone deficiencies were described by Paprosky Grade; Grade I or II were identified in 24 hips, IIIa in 4 hips, IIIb in 28 hips and IV in 3 hips.
Results: We observed 80 hips with aseptic loosening, 10 hips with infection after previous revision, 8 hips with periprosthetic fractures and 2 hips with dislocations. Clinical results improved from a preoperative score of 42 (HHS) to a postoperative mean score of 81.5. The cause of early failure in 4 hips was identified as femoral stem subsidence, and the cause of late failure in 3 hips was due to infection. According to the comparison analysis, there was no statistical significance between femoral bone deficiency (P=0.727) and application of cement (P=0.087), but hips with previous revision surgery showed a higher rate of failure (P=0.024).
Conclusion: Cementless modular stems produced satisfactory results. The main cause of failure was subsidence. A significant risk factor for failure was hips which had undergone previous revision surgery.
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KEYWORD
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Total hip revision, Femoral bone deficiency, Cementless modular femoral stem
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