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A Contemporary Classification System of Femoral Bone Loss in Revision Total Hip Arthroplasty
- Source :
- Arthroplasty Today, Vol 9, Iss, Pp 134-140 (2021), Arthroplasty Today
- Publication Year :
- 2021
- Publisher :
- Elsevier, 2021.
-
Abstract
- Background Current femoral bone loss classification systems in revision total hip arthroplasty were created at a time when the predominant reconstructive methods used cylindrical porous-coated cobalt-chrome stems. As these stems have largely been replaced by fluted-tapered titanium stems, the ability of these classification systems to help guide implant selection is limited. The purpose of this study was to describe a novel classification system based on contemporary reconstructive techniques. Methods We reviewed the charts of all patients who underwent femoral component revision at our institution from 2007 through 2019. Preoperative images were reviewed, and FBL was rated according to the Paprosky classification and compared to ratings using our institution’s NCS. Rates of reoperation at the time of most recent follow-up were determined and compared. Results Four-hundred and forty-two femoral revisions in 330 patients with a mean follow-up duration of 2.7 years were identified. Femoral type according to Paprosky and NCS were Paprosky I (36, 8.1%), II (61, 13.8%), IIIA (180, 40.7%), IIIB (116, 26.2%), and IV (49 11.1%) and NCS 1 (35, 7.9%), 2 (364, 82.4%), 3 (8, 1.8%), 4 (27, 6.1%), and 5 (8, 1.8%). Of the 353 nonstaged rTHAs, there were 42 cases requiring unplanned reoperation (11.9%), including infection (18, 5.1%), instability (10, 2.8%), femoral loosening (5, 1.4%), and various other causes (9, 2.5%). The NCS was more predictive of reoperation than the Paprosky classification (Fisher’s exact test, P = .008 vs P = ns, respectively). Conclusion We present a novel femoral classification system that can help guide contemporary implant selection.
- Subjects :
- Orthopedic surgery
030222 orthopedics
medicine.medical_specialty
business.industry
Compressive osseointegration
Paprosky classification
Massive femoral bone loss
Surgery
03 medical and health sciences
Exact test
0302 clinical medicine
Background current
Femoral component
Medicine
Femoral bone
Orthopedics and Sports Medicine
030212 general & internal medicine
Implant
business
Revision total hip arthroplasty
RD701-811
Total hip arthroplasty
Original Research
Subjects
Details
- Language :
- English
- ISSN :
- 23523441
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Arthroplasty Today
- Accession number :
- edsair.doi.dedup.....9e7cc37214e8647b6d962b5e6e29cc78