Medium Andlong Term Results of Total Hip Revision with a Fluted and Tapered Modular Stem

Abstract：Objective Objective To evaluate medium and long term results of the revision total hip replacement with a fluted,tapered,modular stem. Methods 21 patients(23 hips)underwent revision total hip allhroplasty from May 2000 to March 2009 were reviewed. There were 15 females and 6 males with an average age of 67 years old. 19 patients underwent uni-lateral hip revision and 2 underwent bilateral hip revision. Pre-revision diagnosis showed type Ⅱ(Paprosky classification)in 4 hips,type Ⅲ in 16 hips,and type Ⅲ b in 3 hips,no cases of type Ⅰ or type Ⅳ defects. The acetabular component was SPH (Lima-Lto,Italy),and femoral component wag a fluted and tapered modular stem(Lima-Lto,Italy),the femoral head interface using ceramic-ceramic were 20 cases,metal on polyethylene were 3 cases. Results The mean follow-up was 8. 8 years(range, 6 ~ 13). The Harris hip score improved from(46. 2 ± 8. 2)preoperatively to(90. 3 ± 3. 7)postoperatively,and maintain(91. 3 ± 3. 8)at the latest follow-up. There was significant difference between preoperative and postoperative(t = 54. 50,P ﹤ 0. 01). The mean of the unequal leg length reduced from 3cm preoperatively to 0. 5 cm postoperatively. There was a slight thigh pain(VAS score 1 to 3 points)in 3 hips(13% ),but the symptoms disappeared in the 1 year after the surgery. The X-ray films showed bone ingrowths fixation in 22 hips(96% )and fibrous stable fixation in1 hip(4% ). There were femoral extension osteoectomy in 4 hips,avulsion fracture of the femoral greater trochanter in 3 hips and femoral cortical penetrating fracture in 4 hips. Most of them healed after 4 ~ 6 months. All of the cases showed bone restoration in the proximal defect zone after bone graft without increased radiolucent lines. Conclusion Mid-long term results of revision total hip replacement with a fluted and tapered modular stem is encouraging.