Abstract
In using the S-ROM proximally supported, modular stem for hip revision surgery, the hip is classified into three types after previous implant removal. Type I is an intact isthmus, i.e. the area below the subtrochanteric region. This can be handled with a primary stem. Type II is significant damage to the isthmus and requires a long stem. Type III is no proximal femur over a distance of greater than 70 mm. This requires a long stem with a proximal femoral allograft cemented to the sleeve. A long-term cohort prospective study has been carried out on these cases.
There were 99 in Group 1 (primary stems) with a mean age of 63. Five died at less than two years and four were lost to follow-up. No stems have been removed or revised. The Harris Hip Score is 61.1% excellent, 22.2% good, 10% fair and 6.7% poor. In Group 2 (long stems) there were 157 cases with a mean age of 70. Thirteen died at less than two years and four were lost to follow- up. Seven stems required removal or revision, five for sepsis (mainly in previously septic cases) and two for aseptic loosening. The Harris Score was 58.6% excellent, 18.8% good, 8.3% fair and 14.3% poor. In general, the Harris Hip Score reflects more the function of the glutei. Those with a severe limp can never score excellent. In Group 3 there were five cases, none of which have required stem revision or removal.
In long-term cases polyethylene wear has not been a major feature doubtless reflecting decreased activity level. Osteolysis was also not proved to be a significant problem. There are no cases of osteolysis distal to the sleeve.
The abstracts were prepared by Mrs Dorothy L. Granchi, Course Coordinator. Correspondence should be addressed to her at PMB 295, 8000 Plaza Boulevard, Mentor, Ohio 44060, USA.
