Abstract
Aims: The purpose of this Paper is to review the preliminary results of a new tapered cementless revision stem, the T3, designed for cases of severe bone stock loss (Paprosky 2b, c and 3) usually representing a difficult challenge for the orthopaedic Surgeon. Methods: The T3 stem is made of Titanium alloy with a textured surface finish. The stem consists of a series of distal conical components to achieve a diaphyseal mechanical stability and 4 proximal bodies. The lateral offset is 42 mm and the cervicodiaphyseal angle is 138°. Between December 1998 and September 2001 we have implanted 22 T3 stems in 22 patients. Indications were severe bone loss in 13 cases, failed but stable cemented/cementless stems in 7 cases and peri-prosthetic fracture in 2. 14 patients were male and 8 female, the average age was 70 years. The average follow-up was 27 mo. In all cases a trans-femoral approach was used. The 7 cases with failed but stable stem showed pre-op a Paprosky 1 bone loss. However in these cases a trans-femoral approach was necessary to remove the stem and then a tapered stem became indispensable; 10 patients showed a Paprosky 2 bone loss (A=3 cases, B=3 cases, C=4 cases) and 5 a Paprosky 3. Post-op management was the same of a primary cementless case with full weight-bearing at 30 days. Results: The average Harris score was 40 points pre-op and 87 post-op. Good and Excellent results were 19(86%), 1 was Fair and 2 Poor (9%). Complications were 2 dislocations reduced conservatively and 1 paresis of Peroneal nerve recovered in 5 months. Bone reconstruction was excellent in 19 cases. 14 cases showed no subsidence and 8 < 5mm. Conclusion: T3 showed excellent preliminary results specially for what concerns bone reconstruction and lack of subsidence.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
