Implant breakage and revision factors for modular fluted tapered stems in revision total hip arthroplasty.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-03-01 Epub Date: 2023-06-12 DOI:10.1177/11207000231180065
Thibaut Lucena, Etienne Cavaignac, Louis Courtot, Vincent Marot, Philippe Chiron, Nicolas Reina
{"title":"Implant breakage and revision factors for modular fluted tapered stems in revision total hip arthroplasty.","authors":"Thibaut Lucena, Etienne Cavaignac, Louis Courtot, Vincent Marot, Philippe Chiron, Nicolas Reina","doi":"10.1177/11207000231180065","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Modular stems in revision total hip arthroplasties allow diaphyseal fixation and optimal restoration of the architecture of the proximal femur. Several studies report metaphyseal implant breakage having a negative impact on survivorship. The aim of the study was to evaluate the outcome of an uncemented modular fluted tapered stem (MFT) in revision surgery.</p><p><strong>Methods: </strong>In a retrospective study, 316 patients who had revision surgery using the same design of MFT implant (Modular Revision Stem [MRS], Lima Corporate, Italy) between 2012 and 2017 were identified. Patients were male in 51% of cases and mean age was 74 years. Indications were 110 periprosthetic fractures, 98 periprosthetic joint infection, 97 aseptic loosening, 10 instability and 1 other cause. Survivorship, complications, clinical and radiographic outcomes, were assessed. Mean follow-up was 5 years.</p><p><strong>Results: </strong>There was no implant breakage. At 5-year follow-up, the survivorship, free from revision for aseptic loosening and free of revision for any reason were 96% and 87%, respectively. At last follow-up (8 years), these figures were 92% and 71%, respectively. 31 implants were revised. The risk of revision for any cause was higher for extreme length metaphyseal implants, hazard ratio was 3.7 (95% CI, 1.82-7.52). A mean stem subsidence of 9 mm was noted in 37 cases; 4 were revised for aseptic loosening. The Harris Hip Score at final follow-up was 82.</p><p><strong>Conclusions: </strong>At 5-year follow-up, the MFT implant showed a good survivorship and outcomes with no specific complications. Unlike literature reports, no specific complications occurred with this design. Stem junction positioning and therefore metaphyseal length may be key to optimise long-term survivorship. However, a longer follow-up is needed as implant breakage is more often seen after long implantation times.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"207-214"},"PeriodicalIF":1.3000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIP International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/11207000231180065","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Modular stems in revision total hip arthroplasties allow diaphyseal fixation and optimal restoration of the architecture of the proximal femur. Several studies report metaphyseal implant breakage having a negative impact on survivorship. The aim of the study was to evaluate the outcome of an uncemented modular fluted tapered stem (MFT) in revision surgery.

Methods: In a retrospective study, 316 patients who had revision surgery using the same design of MFT implant (Modular Revision Stem [MRS], Lima Corporate, Italy) between 2012 and 2017 were identified. Patients were male in 51% of cases and mean age was 74 years. Indications were 110 periprosthetic fractures, 98 periprosthetic joint infection, 97 aseptic loosening, 10 instability and 1 other cause. Survivorship, complications, clinical and radiographic outcomes, were assessed. Mean follow-up was 5 years.

Results: There was no implant breakage. At 5-year follow-up, the survivorship, free from revision for aseptic loosening and free of revision for any reason were 96% and 87%, respectively. At last follow-up (8 years), these figures were 92% and 71%, respectively. 31 implants were revised. The risk of revision for any cause was higher for extreme length metaphyseal implants, hazard ratio was 3.7 (95% CI, 1.82-7.52). A mean stem subsidence of 9 mm was noted in 37 cases; 4 were revised for aseptic loosening. The Harris Hip Score at final follow-up was 82.

Conclusions: At 5-year follow-up, the MFT implant showed a good survivorship and outcomes with no specific complications. Unlike literature reports, no specific complications occurred with this design. Stem junction positioning and therefore metaphyseal length may be key to optimise long-term survivorship. However, a longer follow-up is needed as implant breakage is more often seen after long implantation times.

翻修全髋关节置换术中模块化凹槽锥形柄的植入物破损和翻修因素。
目的:翻修全髋关节置换术中使用的模块化柄可实现骺端固定,并对股骨近端结构进行最佳修复。一些研究报告称,骺板植入物断裂会对存活率产生负面影响。本研究旨在评估翻修手术中非骨水泥模块化凹槽锥形柄(MFT)的效果:在一项回顾性研究中,确定了316名在2012年至2017年间使用相同设计的MFT种植体(意大利利马公司的模块化翻修柄[MRS])进行翻修手术的患者。51%的患者为男性,平均年龄为74岁。病因包括110例假体周围骨折、98例假体周围关节感染、97例无菌性松动、10例不稳定性和1例其他原因。对存活率、并发症、临床和影像学结果进行了评估。平均随访时间为5年:结果:没有出现假体破损。在5年的随访中,无菌性松动的存活率为96%,无任何原因的翻修率为87%。最后一次随访(8 年)时,这两个数字分别为 92% 和 71%。有 31 个植入体进行了翻修。极长的骺端植入体因任何原因进行翻修的风险较高,危险比为3.7(95% CI,1.82-7.52)。37例病例的髋臼柄平均下沉9毫米,其中4例因无菌性松动而进行了翻修。最终随访时的Harris髋关节评分为82.分:结论:在5年的随访中,MFT植入体显示出良好的存活率和效果,且无特殊并发症。与文献报道不同的是,该设计未出现特殊并发症。骨干连接位置以及骺端长度可能是优化长期存活率的关键。然而,由于植入时间过长会导致植入体破损,因此需要进行更长时间的随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信