REVISION TOTAL HIP ARTHROPLASTY WITH USE OF THE LINK MP RECONSTRUCTION PROSTHESIS

Abstract

Background: Revision hip arthroplasty in the presence of extensive proximal femoral bone loss constitutes a major challenge. Several reconstruction alternatives have been introduced to deal with the problem of severe proximal bone loss. One of the techniques widely used is bridging the bone defect with the use of a distally fixing implant. The Link- MP reconstruction prosthesis is such a diaphyseal-fixing stem and we report on the early experience with its use.

Methods: The prosthesis has a modular design that allows restoration of hip biomechanics, femoral anteversion and leg length. It is made of a Titanium alloy with a micro-porous surface. The distal part (the stem) has a conical shape that allows cementless anchoring in the femoral diaphysis and it also has 8 or 10 longitudinal grooves, which provide rotational stability.

We report on the early results of its use, mean follow-up 30 months, (range, 9–54 months). Between 1997 and 2001, 32 hip revisions using the Link MP reconstruction prosthesis were performed in 31 patients. There were 13 females and 18 males with a mean age of 65 years (range 35 – 82). The indication for the revision operation was aseptic loosening in twenty-one cases, septic loosening in six and periprosthetic fracture in five cases. Cancellous bone allografts were used in 25 patients. Patients with proven infection were treated by a two-stage procedure.

Results: The mean Merle d’ Aubigne score increased from 6.8 preoperatively to 14.1 postoperatively and there was radiographic evidence of bone regeneration in the proximal femur in 80% of the patients. There were two intraoperative femoral fractures, which didn’t necessitate more than an extension of the partial weight bearing period and healed without complications. No stem was re-revised.

Conclusions: The early results with the use of the Link MP reconstruction prosthesis are encouraging, as shown by the improved patient functional status, the low incidence of complications and the observed proximal femoral bone regeneration.