Intermediate term results of revision total hip replacement with a fluted, and tapered modular stem

Abstract

Objective To evaluate the midterm results of the revision total hip replacement with a fluted and tapered modular stem. Methods Nineteen patients （21 hips） underwent revision total hip arthroplasty from May 2000 to August 2005 were reviewed. There were 13 females and 6 males, with an average age of 67 years. Pre-revision diagnosis included aseptic loosening of the cups and stems associated with femoral defects （Paprosky classification） type Ⅱ 4 hips （19%）, type Ⅲa 14 hips （67%）, and type Ⅲb 3 hips （14%）. The adopted acetabular component was SPH （Lima-Lto, Italy）, and femoral component was a fluted and tapered modular stem （Lima-Lto, Italy）. Clinical and radiographic evaluations were performed postoperatively. Results The mean follow-up was 7 years （range, 5-10）. The Harris hip score improved from 46.2±15.2 preoperatively to 90.3±5.3 postoperatively, and maintain 92.2±3.5 at the latest follow-up. The X-ray films showed bone ingrowths fixation in 20 hips （95%） and fibrous stable fixation in 1 hip （5%）. The average stem subsidence was 2.4 mm （range, 0-10 mm）. There were no re-revisions of the femoral stem for any reason. Conclusion The midterm results of revision total hip replacement with a fluted and tapered modular stem in Paprosky type Ⅱ, Ⅲ a, Ⅲ b femoral defect associated aseptic loosening of the femoral stem was encouraging. Key words: Arthroplasty, replacement,hip; Reoperation; Prosthesis design