Early radiological and functional outcomes for a cementless press-fit design modular femoral stem revision system

Abstract

Aim:

To assess early radiological and functional outcomes of revision hip surgery with a cementless press-fit design femoral stem.

Patients and methods:

A retrospective review of 48 consecutive revision total hip replacements using the RECLAIM revision hip system, between October 2012 and August 2015. Radiographic assessment was undertaken with serial anteroposterior (AP) X-rays of the pelvis. Risk factors for subsidence were evaluated. Prospective clinical follow up was performed on 21 patients to assess functional outcomes.

Results:

Mean stem subsidence was 1.1 mm (95% confidence interval[CI]: 0.63–1.57). Median follow up of 12 months. An inverse relationship was observed between level of subsidence and femoral stem diameter r = −0.45, p = 0.001. Subsidence at the time of follow-up assessment was correlated with initial subsidence (correlation coefficient rho 0.69, p = 0.001). The mean Merle d’Aubigne score at the latest follow up was 14.2 (range 8–17). The mean OHS was 34.1 (range 15–48).

Conclusion:

Early radiological and functional outcomes for the RECLAIM revision system showed very low levels of subsidence and good functional outcomes. There was an association with smaller diameter femoral stems and greater levels of subsidence.

Keywords

Arthroplasty migration revision arthroplasty subsidence

Get full access to this article

View all access options for this article.

References

New Zealand Orthopaedic Association. The New Zealand Joint Registry seventeen year report January 1999 to December 2015. www.nzoa.org.nz/nz-joint-registry (2016, accessed 20 November 2016).

Sanchez-Sotelo

Haidukewych

Boberg

. Hospital cost of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am 2006; 88: 290–294.

Moreland

Bernstein

. Femoral revision hip arthroplasty with uncemented, porous coated stems. Clin Orthop 1995; 319: 141–150.

Noble

Alexander

Lindahl

et al . The anatomic basis for femoral component designs. Clin Orthop 1988; 235: 148–165.

Ayers

Drew

Hays

et al . Early micromotion of a tapered femoral stem in cementless total hip replacement. J arthroplasty 2009; 24: e77.

Girard

Roche

Wavreille

et al . Stem subsidence after total hip revision: 183 cases at 5.9 years follow-up. Orthop Traumatol Surg Res 2011; 97: 121–126.

Eckrich

Noble

Tullos

. Effect of rotation on the radiographic appearance of the femoral canal. J Arthroplasty 1994; 9: 419–426.

Farfalli

Boland

Morris

et al . Early equivalence of uncemented press-fit and compress femoral fixation. Clin Orthop Relat Res 2009; 467: 2792–2799.

Merle D’Aubigné

. [Numerical evaluation of hip function]. Rev Chir Orthop Repar Appar Mot 1970; 56: 481–486.

10.

McInnis

Horne

Devane

. Femoral revision with a fluted, tapered, modular stem seventy patients followed for a mean of 3.9 years. J Arthroplasty 2006; 21: 372–380.

11.

Bohm

Bischel

. The use of tapered stems for femoral revision surgery. Clin Orthop Relat Res 2004; 420: 148–159.

12.

Weeden

Paprosky

. Minimal 11-year follow-up of extensively porous-coated stems in femoral revision total hip arthroplasty. J Arthroplast 2002; 17(Suppl. 1): 134–137.

13.

Grünig

Morscher

Ochsner

. Three- to 7-year results with the uncemented SL femoral revision prosthesis. Arch Orthop Trauma Surg 1997; 116: 187–197.

14.

Kolstad

Adalberth

Mallmin

et al . The Wagner revision stem for severe osteolysis: 31 hips followed for 1.5–5 years. Acta Orthop Scand 1996; 67: 541–544.

15.

Weber

Hempfing

Orler

et al . Femoral revision using the Wagner stem: results at 2–9 years. Int Orthop 2002; 26: 36–39.

16.

Morscher

. Experience with the press-fit cup and press-fit gliding stem. In: Kusswetter

(ed.) Noncemented total hip replacement. Proceedings of International Symposium, 1990. New York, Stuttgart: Thieme, 1991, pp.221–231.

17.

Duymus

Solak

Ozturkmen

et al . Mid-term results of previously cemented hip arthroplasties revised with uncemented modular femoral components: a retrospective study. J Orthop Surg Res 2015; 10: 123.

18.

Kalairajah

Azurza

Hulme

et al . Health outcome measures in the evaluation of total hip arthroplasties: a comparison between the Harris hip score and the Oxford hip score. J Arthroplasty 2005; 20: 1037–1041.