Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

INTRA-OPERATIVE COMPLICATIONS OF REVISION THA USING AN UNCEMENTED DISTALLY SLOTTED, FLUTED FEMORAL STEM



Abstract

Introduction and Aims: The use of porous coated femoral stems in revision hip arthroplasty has been associated with a high rate of complications including femoral fracture, femoral perforation and eccentric reaming. The purpose is to determine if using a distally slotted-fluted femoral stem is associated with lower incidence of the above three intra-operative complications.

Method: The intra-operative complications of 175 cementless revision total hip arthropasties (THA) using a distally slotted-fluted femoral stem were reviewed. Three categories of complications were recorded: femoral fracture, femoral perforation and eccentric reaming. Radiographic evaluation was based on standard antero-posterior and lateral views of the hip joint performed in the intra-operative or immediate post-operative period. Statistical analysis for factors associated with complications was performed using the chi-square test.

Results: Intra-operative complications occurred in 16 patients (9.1%). There was no statistically significant association between complication rate and type of surgical approach, stem length, stem diameter, or host bone quality. The complication rate was significantly lower than the 44% total complication rate previously reported utilising a long, solid, extensively coated revision stem without a slot or flute (p< .01). These results are consistent with laboratory testing, which revealed significantly lower bone strains at the isthmus when inserting a long cementless revision stem with a slot and flute compared to a solid fully coated stem of identical geometry.

Conclusion: The use of a distally slotted fluted porous coated femoral stem in revision hip arthroplasty results in a dramatically lower complication rate compared to rates previously reported for solid porous stems. These results strongly support the continued use of such a prosthesis for revision THA.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

At least one of the authors is receiving or has received material benefits or support from a commercial source.