Abstract
Introduction. The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications. The ROBODOC system has been designed to selectively remove bone cement from the femoral canal, but results have not been reported yet. The purpose of our study was to evaluate the clinical and radiographic results of revision THA using the ROBODOC system for cement removal. Materials and Methods. The subjects comprised 19 patients who underwent revision THA using the ROBODOC system. The minimum duration of follow-up was 76 months (median, 109 months; range, 76–150 months). The extent of remaining bone cement on postoperative radiography, timing of weight bearing, and the complications were evaluated. Results. The mean Merle d'Aubigne and Postel score increased from 10 points preoperatively to 14 points by final follow-up. Bone cement was completely removed in all cases. Full weight bearing was possible within 1 week after surgery in 9 of the 19 cases and within 2 months in all remaining cases. No instances of perforation or fracture of the femur were encountered. Conclusions. Bone cement could be safely removed using the ROBODOC system, and no serious complications occurred. Full weight bearing was achieved early in the postoperative course because of circumferential preservation of the femoral cortex.
Highlights
The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications
Extended trochanteric osteotomy was introduced for difficult situations in revision THA [8,9,10,11], but good results have not necessarily been obtained with the procedure in terms of intraoperative femoral fracture [8, 10, 12]
We reviewed the medical records and radiographs of the studied subjects after the approval of this study by the institutional review board committee
Summary
The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications. The ROBODOC system has been designed to selectively remove bone cement from the femoral canal, but results have not been reported yet. The perforation and fracture of the femur during the removal of bone cement in revision total hip arthroplasty (THA) are serious complications that considerably affect the postoperative protocols and clinical results [1]. Using ROBODOC, the rate of intraoperative femoral fissures was significantly lower than that of the hand rasping conventional THA [16] This system can selectively remove bone cement from the femoral canal in revision THA [13].
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