AORI Presentations at the
2001 Annual Meeting of the American Association of Orthopaedic Surgeons

 

 


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Revision with an extensively porous-coated stem is an effective long-term reconstructive technique for patients with extensive femoral bone loss.

Extensively Porous-Coated Femoral Revision for Severe Femoral Bone Loss: Minimum Ten-Year Follow-up

C. Anderson Engh, Jr., MD, Thomas J. Ellis, MD, Lisa M. Koralewicz, MPH, James P. McAuley, Charles A. Engh MD

This study reviews minimum 10-year results of revision total hip arthroplasties using fully porous-coated, long-stemmed femoral prostheses to address extensive diaphyseal bone loss.
Materials & Methods: Of 275 femoral revisions performed at our institution between 1982 and 1986, we identified 34 patients (35 hips) whose femoral bone quality was compromised at least 10 cm below the lesser trochanter. The patients had been revised with fully porous-coated femoral components that were 190 mm or longer (Anatomic Medullary Locking, DePuy, Johnson & Johnson) to address their extensive diaphyseal bone damage.

We evaluated the patients clinically and radiographically at a minimum of 10 years after revision surgery.

Results: Two patients (2 hips) had less than 10-year follow-up, and 7 patients (7 hips) died before a 10-year examination, which left 25 patients (26 hips) with a mean follow-up of 13.3 years (range: 10-16 years)

Results
25 patients (26 hips) with mean 13.3 year followup:

3 stems re-revised:
(1 aseptic loosening, 1 septic loosening, 1 fractured femoral component)

3 loose stems that do not warrant revision

Femoral aseptic loosening rate: 15% (4/26 hips).

Survivorship at 10 years, using femoral revision as an endpoint: 89% (95% confidence interval; 77 to 100%). (Kaplan-Meier)

Eighty-six percent of patients (19/22 hips) with an intact femoral component were satified with their outcome at minimum 10-year follow-up.

Conclusion: an effective long-term reconstructive technique for total hip arthroplasty patients with extensive femoral bone loss is a revision using an extensively porous-coated femoral component.

For other research published from 1999-2001, go to:
Knee Research

Hip
Research

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