Outcomes of femoral component revision using uncemented modular titanium stems and the effect of the distal design | ||||
| Minia Journal of Medical Research | ||||
| Volume 31, Issue 3, July 2020, Page 50-61 PDF (397.63 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjmr.2022.219859 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Ibrahim El-hawary; Hesham Ali; Mohamed El-Shafie; Karam R. Abdelsamie | ||||
| Department of Orthopedic, El-Minia Faculty of Medicine | ||||
| Abstract | ||||
| Aim of the work: Femoral revision component subsidence has been identified as predicting early failure in revision hip surgery. This comparative cohort study assessed the potential risk factors of subsidence in two commonly used femoral implant designs. Patients and Method: A comparative cohort study was undertaken, analyzing a consecutive series of patients following revision total hip arthroplasties using either a tapered-modular (TM) fluted titanium or a porous-coated cylindrical modular (PCM) titanium femoral component, between April 2006 and May 2018. Clinical and radiological assessment was compared for both treatment cohorts. Risk factors for subsidence were assessed and compared. Results: In total, 65 TM and 35 PCM cases were included. At mean followup of seven years (one to 13), subsidence was noted in both cohorts during the initial three months postoperatively (p < 0.001) then implants stabilized. Subsidence noted in 58.7% (38/65cases) of the TM cohort (mean 2.3 mm) compared to 48.8% (17/35) of PCM cohort (mean 1.9 mm; p = 0.344). Subsidence of PCM cohort were significantly associated with extended trochanteric osteotomy (ETO) (p < 0.041). Although the ETO was used less frequently in PCM stem cohort (7/35), subsidence was noted in 85% (6/7) of them. Significant improvement of the final mean Oxford Hip Score (OHS) was reported in both treatment groups (p < 0.001). Conclusion: Both modular TM and PCM revision femoral components subsided within the femur. TM implants subsided more frequently than PCM components if the femur was intact but with no difference in clinical outcomes. However, if an ETO is performed then a PCM component will subside significantly more and suggests the use of a TM implant may be advisable. | ||||
| Keywords | ||||
| Femoral; arthroplasties; femoral implant designs | ||||
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