Abstract
There is an increasing trend towards cementless modular femoral prostheses for revision hip replacement surgery, especially in patients with severe proximal femoral bone defects. However, for minor femoral bone defects, the benefit of cementless modular is not clear. We designed a retrospective cross-sectional study to compare outcomes of the two femoral implant designs. There were no significant differences in terms of visual analog pain scores, Harris hip scores, femoral bone restoration, stem subsidence, leg length correction, or overall complication rate. Three femoral reoperations (11%) occurred in the cemented group, and two (9%) in the cementless modular group. One femoral stem re-revised (4%) in the cemented group due to recurrent deep infection. Five-year survival for femoral reoperation was 88.2% for patients with the cemented implant and 91.3% for cementless group. Both groups had good clinical and radiological outcomes for femoral revision in patients with minor femoral bone defects during medium-term follow-up.
Highlights
There is an increasing trend towards cementless modular femoral prostheses for revision hip replacement surgery, especially in patients with severe proximal femoral bone defects
The modular femoral component works on the principle of distal fixation in the diaphysis of the femur
There are varying opinions about whether uncemented implants are better than cemented for revision hip replacement
Summary
There is an increasing trend towards cementless modular femoral prostheses for revision hip replacement surgery, especially in patients with severe proximal femoral bone defects. Five-year survival for femoral reoperation was 88.2% for patients with the cemented implant and 91.3% for cementless group Both groups had good clinical and radiological outcomes for femoral revision in patients with minor femoral bone defects during medium-term follow-up. Some studies showed good clinical results during femoral revision when a cemented stem was used in conjugation with an impacted bone graft[2,3,4]. The modular femoral component works on the principle of distal fixation in the diaphysis of the femur This facilitates the intraoperative adjustment of leg length, femoral offset, and neck anteversion to maximize implant stability and hip kinematics. Excellent clinical results in several previous studies[9,10,11] encouraged the application of this modular femoral stem in hip revision
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