REVISION OF ARTICULAR COMPONENTS IN TOTAL HIP ARTHROPLASTY WITH WELL FIXED SOCKETS AND STEMS (“PIT-STOP” SURGERY)

Abstract

The improvement of the anchorage surfaces of the total hip arthroplasty (THA) has allowed a better bone integration of the stem and of the cup more durable in the time and often more advanced to the duration of those articular components subject to wear.

In case of lesion of one of these components, our study group (Arthro Surgery Group) has created a standard protocol for the revisions of total hip arthroplasty with well fixed stems and shells (PIT-STOP). We operated 22 patients with THA more than 10 years ago after the first implantation.

The average HARRIS HIP SCORE post-op is 92 in 1 year follow-up. The X-rays exams are excellent.

In case of wear of the polyethylene liner or of the head, we proceed to the substitution of the components if available and if the fixation mechanism is not damaged. In case of old designed THA, with articular components not available (polyethylene liner for the cup and ceramic or metal head), we use the liner fixation by cementation into the well fixed original metal back and a new head. If an alteration or an anomalous size of the neck is evidenced, we put on a metallic special device of measure adapted (taper case) on which we put a new ceramic head. In case of fracture of a ceramic head, we remove all the fragments and put on the prosthetic neck a new ceramic head with the metallic special device (taper case), after many washing and radical sinoviectomy.