1. Femoral Bone Is Preserved Using Cemented Polished Stems in Young Patients.
- Author
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Howie, Donald, Costi, Kerry, McGee, Margaret, Standen, Angela, and Solomon, Lucian
- Subjects
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FEMUR , *BONE cements , *REOPERATION , *BONE grafting , *TOTAL hip replacement , *RADIOGRAPHY , *ORTHOPEDICS - Abstract
Background: Techniques that ensure femoral bone preservation after primary THA are important in younger patients who are likely to undergo revision surgery. Questions/purposes: We examined femoral stem survival, bone deficiency at revision arthroplasty, and radiographic bone loss in hips implanted with a cemented polished double-taper stem in a cohort of patients younger than 55 years. Methods: We reviewed 197 hips (median patient age, 47 years; range, 16-54 years) after a minimum followup of 2 years (median, 7 years; range, 2-19 years) since primary THA. Clinically, we determined survival to major and minor stem revision and cases of bone deficiency requiring a long stem or impaction bone grafting or created by the need for femoral osteotomy at revision arthroplasty. Radiographically, we assessed stem loosening, femoral osteolysis, and femoral bone deficiency. Results: Stem survival to major revision for aseptic loosening was 100% at 13 years and for any reason was 97% (95% CI, 93-100%). At revision of seven stems, a long stem was used in one hip, a total femoral replacement in one hip and impaction bone grafting in one hip. No femoral osteotomies were required. Bone was preserved in four hips by cement-within-cement stem exchange. No stems were radiographically loose. Proximal osteolysis was present in 11% of femurs. Femoral bone deficiency was graded as Paprosky Type I (97%) or II (3%) and Endo-Klinik Grade 0 (79%) or I (21%). Conclusions: Cemented polished taper stems have high survival at 13 years in young patients and enable femoral bone preservation for subsequent revision. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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