Fixation of a modular curved revision stem with a taper of 2° in the femur.

Abstract

Modular revision stems with a short distal component can prevent the bypassing of the femoral isthmus and hereby theoretically have advantages concerning risk of periprosthetic fractures, breakage of the junction and a technically easier revision procedure. Radiological evaluation of 202 stem revision operations with the modular curved revision stem "Revitan Curved" with a 2° taper was carried out after a mean follow-up period of 7.44 ± 2.09years (3-13years) to investigate whether short-stem combinations are effective in Paprosky 2 and 3A defects with respect to rate of subsidence and loosening. Sixty of 62 endofemoral (96.8%) and 137 of 140 transfemoral implantations (97.9%) involved the short, 140mm distal component. Significant subsidence was seen in 3.3% of cases following endofemoral implantation and in 2.1% of cases following transfemoral implantation. Neither aseptic loosening nor periprosthetic fracture were observed. The use of combinations of short modular components leads to reproducibly good outcomes in femoral revision with respect to subsidence and loosening.