Clinical outcomes of using nonmodular tapered long stem in femoral revision with Paprosky Ⅲ bone defect
10.16571/j.cnki.1008-8199.2018.04.009
- VernacularTitle:非组配型全涂层锥形长柄假体对股骨侧严重骨缺损病例翻修的临床疗效
- Author:
Liang LI
1
;
Pei-Liang FU
;
Chuan-Xin ZHANG
;
Jia-Hua SHAO
;
Yi-Qin ZHOU
;
Xiao-Hua LI
;
Hai-Shan WU
Author Information
1. 第二军医大学附属上海长征医院关节外科
- Keywords:
revision;
bone defect;
hip;
arthroplasty;
replacement;
nonmodular revision stem
- From:
Journal of Medical Postgraduates
2018;31(4):381-385
- CountryChina
- Language:Chinese
-
Abstract:
Objective It is a great challenge to perform hip revision surgery especially with severe proximal femoral bone de -fect.This study aims to discuss the short-medium clinical outcomes of using nonmodular full-coated tapered stem in femoral revision with Paprosky Ⅲ bone defect. Methods From May 2011 to October 2015, 58 patients(58 hips)diagnosed as ostiolysis/aseptic loosening with severe femoral bone defect(Paprosky Ⅲ)were treated with hip revision surgery.The cases of septic loosening and tumor were excluded.Harris scoring system and pain visual analogue scale(VAS)were used pre-and post-operatively to evaluate the function of hip joints and the pain level.Radiograph was used to evaluate loosening,subsidence and bone healing of the prosthesis. Results All patients were followed-up with 24-67 months,the mean follow up time was 49.3±12.7 months.None of the patients showed infec-tion or surrounding bone fracture.Dislocation happened in one case after surgery and was treated with manipulative reduction without re -currence.One case had progressive subsidence which led to aseptic loosening and was treated with re-revision.By the end of last follow-up,Haris Score was improved from preoperative 41.6±6.9 points to 83.1±5.7 points, VAS score decreased from preoperative 6.7 ±1.6 points to 2.5 ±1.2 points,(P<0.05). Conclusion Nonmodular full-coated tapered stem can obtain good clinical effect in femoral revision with severe proximal bone defect.
