Abstract
Objective: Revision total hip arthroplasty in cases of proximal femoral bone loss due to osteolysis and loosening is challenging for surgeon and implants. The use of tapered fluted modular titanium femoral stem in these situations may offer the advantage of better biomechanical reconstruction with a design that ensure primary stability and promotes bone integration.
Method: We studied retrospectively 83 cases of femoral reconstruction with the PFM-R stem. Paprosky classification was used to qualify bone defects on preoperative radiological evaluation. Demographic, clinical and intraoperative data were collected, along with any complications. Clinical (W.O.M.A.C. function score) and radiological follow-up was performed at a minimum of 12 months.
Results: The mean follow-up was 44 months (23 to 66 months). Five patients were lost to follow-up. 48% of patients had at least one previous revision. The mean post operative WOMAC score was 83. 91% of patients had no significant limb length discrepancy. Stabilization or regression of osteolytic lesions was observed in 75% of revised femur. Complications were 8 dislocations, 7 fractures and 3 infections. A correlation was found between the risk of dislocation and the number of previous revision surgery. Out of 14 cases revised for infection, one had a recurrence.
Discussion: This study confirmed the benefits of the PFM-R stem in difficult femoral revision in term of limb length equalization, stability of fixation, regression of osteolytic lesions and improved clinical function.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
