Application of SL-PLUS/SLR-PLUS cementless stem prosthesis in treating femoral bone defects in total hip revision surgery
10.3760/cma.j.issn.0253-2352.2016.23.008
- VernacularTitle:非骨水泥锥形方柄在股骨近端骨缺损翻修重建中的应用
- Author:
Jian WANG
;
Jun XIAO
;
Liang ZHAO
;
Tao LI
;
Yang ZHANG
;
Xianzuo ZHANG
;
Zhanjun SHI
- Keywords:
Arthroplasty,replacement,hip;
Prosthesis failure;
Reoperation;
Femur;
Osteolysis
- From:
Chinese Journal of Orthopaedics
2016;36(23):1517-1523
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the technique and clinical results of rectangular SL-PLUS/SLR-PLUS cementless stem prosthesis in treating femoral bone defects in total hip revision surgery.Methods A retrospective analysis was performed involving 57 patients underwent total hip revision using SL-PLUS/SLR-PLUS cementless stem prosthesis for femoral defects from October 2000 to April 2014,including 22 males and 35 females with average age 62 years (range 44 to 83 years).All patients underwent unilateral surgery,21 in the left and 36 in the right.Eighteen cases of Paprosky Ⅱ,23 cases of type ⅢA and 16 cases of type ⅢB were included.Revision surgeries were performed using uncemented rectangular SL-PLUS/SLRPLUS femoral stems.Femurs were split in 12 cases without bone grafting.Acetabulum revision or acetabuloplasty were conducted in 51 cases by the use of 33 spherical cups and 18 reinforcement rings.Signs for prosthesis loosing such as transparent line around prosthesis,osteolysis and subsidence were recorded at the follow-ups.The clinical effects were evaluated using visual analogue scale (VAS),Harris score and activity daily life (ADL) score.Results The average operation was 108 min,ranging from 100 to 170 min.The average blood loss was 660 ml,ranging from 300 to 850 ml.All prostheses were placed optimally and received press-fit stability in the initial state.No neurological or vascular complication occurred during or after the operation.All incision healed at stage Ⅰ without nerve traction injury,joint dislocation,fractures,acute infection and lower limb deep vein thrombosis.The average follow-up duration was 4.8 years,ranging from 2 to 16 years.Total VAS improved from 6.54±1.56 to 2.28± 1.46 (t=17.335,P＜0.001).The Harris score improved from 46.74±7.95 to 78.46±8.25 (t=-25.012,P＜0.001),and the ADL scores increased from 56.84±6.86 to 69.39±7.56 (t=-21.309,P＜O.001).No prosthesis subsidence,prosthesis fracture and other complications occurred during the follow-up.Transparent lines around the upper part of the prosthesis were observed in 18 cases.All prosthesis-bone union was intact in the distal parts.Conclusion The segmental functional reconstruction with cementless rectangular SL-PLUS/SLR-PLUS stem prosthesis is a safe and reliable surgical procedure in patients with Paprosky Ⅱ or Ⅲ bone defects.
