scholarly journals SURGICAL TREATMENT OF ISOLATED ASEPTIC ACETABULAR LOOSENING IN PATIENTS WITH STABLE FEMORAL COMPONENT

2018 ◽  
Vol 73 (3) ◽  
pp. 164-171
Author(s):  
D. A. Markov ◽  
K. P. Zvereva ◽  
A. V. Sertakova ◽  
V. N. Belonogov ◽  
A. Yu. Troshkin
Keyword(s):  
Surgical Treatment ◽  
Femoral Component ◽  
Friction Pair ◽  
Hip Revision ◽  
Total Hip ◽  
Delayed Complications ◽  
Oxford Hip Score ◽  
Acetabular Loosening ◽  
Blood Loss Volume

Background: Aseptic acetabular loosening currently occupies the 1st place in the structure of delayed complications after total hip arthroplasty. The basis of treatment is the replacement of a loosening cup and a pair of friction. The tactics of surgical treatment of the stable correctly oriented femoral component have not been determined, thoroughly which confirms the relevance of the study.Aims: Compare the effectiveness of total hip revision and isolated acetabular revision in patients with aseptic acetabular loosening and stable correctly oriented femoral component.Materials and methods: The study presented the results of surgical treatment performed in 44 patients (45 revisions) with isolated aseptic acetabular loosening and stable correctly oriented femoral component were presented, Patients were divided into two groups depending on the severity of surgery. The first group included 16 patients with a total revision due to irregular cone of the stem. The second group included 28 patients (29 revisions) with an isolated replacement of the unstable cup and a pair of friction.Results: In the 1st group, revision surgery was performed to replace both cup with the friction pair and stable correctly oriented stem which finally results in lower postoperative red blood counts (erythrocytes, hemoglobin, hematocrit), as well as higher intraoperative blood loss volume and longer duration of surgical intervention if compare to the 2nd group where the stable correctly oriented femoral component was not changed. Postoperative results assessed using Harris scales and Oxford Hip Score in the comparison group were at a higher level during the whole period of follow-up. A moderate coorelation between the severity of the revision intervention and its results was detected.Conclusions: Preservation of a stable correctly oriented stem allows to reduce the severity of the revision intervention which improves the results and shortens the period of patient rehabilitation.

Cement-in-cement femoral component revision

2021 ◽  
Vol 103-B (7) ◽  
pp. 1215-1221
Author(s):  
John W. Kennedy ◽  
Nigel Y. B. Ng ◽  
David Young ◽  
Nicholas Kane ◽  
Andrew G. Marsh ◽  
...  
Keyword(s):  
Femoral Component ◽  
Short Form ◽  
Demographic Data ◽  
Senior Author ◽  
Inclusion Criteria ◽  
Reliable Technique ◽  
Patient Demographic Data ◽  
Oxford Hip Score ◽  
Component Revision

Aims Cement-in-cement revision of the femoral component represents a widely practised technique for a variety of indications in revision total hip arthroplasty. In this study, we compare the clinical and radiological outcomes of two polished tapered femoral components. Methods From our prospectively collated database, we identified all patients undergoing cement-in-cement revision from January 2005 to January 2013 who had a minimum of two years' follow-up. All cases were performed by the senior author using either an Exeter short revision stem or the C-Stem AMT high offset No. 1 prosthesis. Patients were followed-up annually with clinical and radiological assessment. Results A total of 97 patients matched the inclusion criteria (50 Exeter and 47 C-Stem AMT components). There were no significant differences between the patient demographic data in either group. Mean follow-up was 9.7 years. A significant improvement in Oxford Hip Score (OHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 12-item Short-Form Survey (SF-12) scores was observed in both cohorts. Leg lengths were significantly shorter in the Exeter group, with a mean of -4 mm in this cohort compared with 0 mm in the C-Stem AMT group. One patient in the Exeter group had early evidence of radiological loosening. In total, 16 patients (15%) underwent further revision of the femoral component (seven in the C-Stem AMT group and nine in the Exeter group). No femoral components were revised for aseptic loosening. There were two cases of femoral component fracture in the Exeter group. Conclusion Our series shows promising mid-term outcomes for the cement-in-cement revision technique using either the Exeter or C-Stem AMT components. These results demonstrate that cement-in-cement revision using a double or triple taper-slip design is a safe and reliable technique when used for the correct indications. Cite this article: Bone Joint J 2021;103-B(7):1215–1221.

Outcomes and survivorship after conversion of failed hip hemiarthroplasty to total hip arthroplasty

2019 ◽  
pp. 112070001989142 ◽  
Author(s):  
Nana O Sarpong ◽  
Matthew J Grosso ◽  
Akshay Lakra ◽  
Carl L Herndon ◽  
Emma Jennings ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Femoral Component ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Complication Rates ◽  
Conversion Surgery ◽  
Total Hip ◽  
Estimated Blood Loss

Background: Arthroplasty is the treatment of choice for elderly patients with displaced femoral neck fractures. When compared to total hip arthroplasty (THA), higher revision rates have been reported for hemiarthroplasty (HA). Conversion of failed HA to THA can be complex, especially in the elderly population at risk for revision surgery complications. We report a single institution’s experience with conversion of failed HA to THA at mid-term follow-up. Methods: We identified patients converted from failed HA to THA from 2006 to 2016. Clinical data including indication for index and conversion surgery, maintenance or revision of femoral component during conversion, operative time, estimated blood loss, postoperative complications, and need for revision surgery were collected. Descriptive statistics were analysed in SPSS. Results: The cohort included 21 men and 39 women (mean age of 74.5 years). The mean follow-up after conversion HA to THA was 2.8 years. During conversion surgery, the femoral component was revised in 75.0% and retained in 25.0% of cases. After conversion HA to THA, the rate of major complications and re-revision at 2 years was 11.7% and 10.0%, respectively. Femoral revision versus retention did not affect complication rates (11.1% vs. 6.7%; p = 0.31) or re-revision rates (8.9% vs. 13.3%; p = 1.0). Conclusions: In this high-risk population, mid-term follow-up demonstrated tolerable complication and re-revision rates, the majority of which were for instability. We observed high rates of femoral component revision during conversion THA, although this did not increase the likelihood of postoperative complications or need for future surgery.

Results of Cemented Femur Components Application at Total Hip Revision Arthroplasty

2012 ◽  
Vol 19 (3) ◽  
pp. 32-38
Author(s):  
N. V Zagorodniy ◽  
V. I Nuzhdin ◽  
K. M Bukhtin ◽  
S. V Kagramanov
Keyword(s):  
Revision Arthroplasty ◽  
Treatment Results ◽  
Indication For Surgery ◽  
Hip Revision ◽  
Hip Revision Arthroplasty ◽  
Total Hip ◽  
Level 1 ◽  
Type 3 ◽  
Fatigue Fractures

Treatment results for 114 total hip revision arthroplasties (1992—2011) with cemented femur components were analyzed. The most common indication for surgery was aseptic instability of hip implant. In 1 st group (42 operations) cemented stems Bi-Metric (Biomet Orthopaedics) and in 2 nd group (72 operations) cemented stems ESI (Endoservis) were used. Surgical technique was described and causes of complication development were analyzed. Mean follow-up made up 11 years. In the 1 st group excellent results were achieved in 2 (4.76%) cases, good in 34 (80.95%), satisfactory in 3 (7.14%) and poor in 3 (7.14%) cases. In the 2 nd group corresponding results were achieved in 3 (4.17%), 47 (65.28%), 15 (20.83%) and 7(9.72) respectively. Analysis of the reasons for complication development was performed. It was stated that femur defects of type 3 on level 1 by AAOS classification resulted in fatigue fractures of cemented revision stems.

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