Publication:
Surgical Technology International XX - Orthopaedic Surgery
Article title:
Femoral Revision with Taper Stems: Results at Ten Years Follow-up
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Author(s)
Paolo Cherubino, MD
Professor and Chief, Department of Orthopedics
University of Insubria
Varese, Italy
Alessandro Fagetti, MD
Department of Orthopedics
University of Insubria
Varese, Italy
Fabio D'Angelo, MD
Associate Professor, Department of Orthopedics
University of Insubria
Varese, Italy
Michele Francesco Surace, MD
Associate Professor, Department of Orthopedics
University of Insubria
Varese, Italy
Abstract
In the case of extensively damaged meta-diaphyseal femoral bone with cortices thinning and widened femoral canal, tapered stems allow a good primary fixation and early weight-bearing. A retrospective review was conducted to evaluate long-term results of modular revision taper stems implanted from March 1999 to December 2002. Sixty-five consecutive hip revision surgeries were performed, mostly for aseptic loosening (75% of the cases). Femoral bone stock defects were classified according to AAOS's criteria and consisted mainly in type II (cavitary defects, 44.6%) and type III (combined defects, 33.9%). A trochanteric osteotomy was performed in 25 cases (38%) to remove primary implants that were cemented in 35 cases (54%). The mean postoperative follow-up was 109 months (range, 76 to 131 months). Clinical assessment at follow-up showed a significantly improved mean Harris Hip Score from 42 points preoperatively to 81 points postoperatively, while the x-ray examination did show a satisfactory distal integration of the stem in all cases and satisfactory reconstitution of the femoral bone stock in 47% of cases. The average subsidence of the stem at follow-up was less than one millimeter. According to data analysis, a leg-length discrepancy exceeding 15 millimeters caused significantly worse functional outcome and pain.
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