Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem: 5- to 16-year results of 163 cases.

Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem: 5- to 16-year results of 163 cases.

Acta orthopaedica (2014-09-02)

Dieter C Wirtz, Sascha Gravius, Rudolf Ascherl, Miguel Thorweihe, Raimund Forst, Ulrich Noeth, Uwe M Maus, Matthias D Wimmer, Günther Zeiler, Moritz C Deml

PMID25175667

ZUSAMMENFASSUNG

Due to the relative lack of reports on the medium- to long-term clinical and radiographic results of modular femoral cementless revision, we conducted this study to evaluate the medium- to long-term results of uncemented femoral stem revisions using the modular MRP-TITAN stem with distal diaphyseal fixation in a consecutive patient series. We retrospectively analyzed 163 femoral stem revisions performed between 1993 and 2001 with a mean follow-up of 10 (5-16) years. Clinical assessment included the Harris hip score (HHS) with reference to comorbidities and femoral defect sizes classified by Charnley and Paprosky. Intraoperative and postoperative complications were analyzed and the failure rate of the MRP stem for any reason was examined. Mean HHS improved up to the last follow-up (37 (SD 24) vs. 79 (SD 19); p<0.001). 99 cases (61%) had extensive bone defects (Paprosky IIB-III). Radiographic evaluation showed stable stem anchorage in 151 cases (93%) at the last follow-up. 10 implants (6%) failed for various reasons. Neither a breakage of a stem nor loosening of the morse taper junction was recorded. Kaplan-Meier survival analysis revealed a 10-year survival probability of 97% (95% CI: 95-100). This is one of the largest medium- to long-term analyses of cementless modular revision stems with distal diaphyseal anchorage. The modular MRP-TITAN was reliable, with a Kaplan-Meier survival probability of 97% at 10 years.

MATERIALIEN

Produktnummer

Marke

Produktbeschreibung

348791

Sigma-Aldrich

Titan, foil, thickness 0.127 mm, 99.7% trace metals basis

366994

Sigma-Aldrich

Titan, powder, <45 μm avg. part. size, 99.98% trace metals basis

267503

Sigma-Aldrich

Titan, foil, thickness 0.25 mm, 99.7% trace metals basis

268496

Sigma-Aldrich

Titan, powder, −100 mesh, 99.7% trace metals basis

268526

Sigma-Aldrich

Titan, sponge, 1-20 mm, 99.5% trace metals basis

460400

Sigma-Aldrich

Titan, wire, diam. 0.25 mm, 99.7% trace metals basis

GF16031843

Titan, mesh, 100x100mm, nominal aperture 0.19mm, wire diameter 0.23mm, 60x60 wires/inch, open area 20%, twill weave

369489

Sigma-Aldrich

Titan, foil, thickness 2.0 mm, 99.7% trace metals basis

348848

Sigma-Aldrich

Titan, foil, thickness 0.025 mm, 99.98% trace metals basis

348805

Sigma-Aldrich

Titan, foil, thickness 0.5 mm, 99.99% trace metals basis

767506

Sigma-Aldrich

Titan, sputtering target, diam. × thickness 2.00 in. × 0.25 in., 99.995% trace metals basis

GF29374005

Titan, mesh, 100x100mm, nominal aperture 4.3mm, wire diameter 1.5mm, 4.4x4.4 wires/inch, open area 94%, platinized diamond mesh

460397

Sigma-Aldrich

Titan, foil, thickness 0.127 mm, ≥99.99% trace metals basis

267481

Sigma-Aldrich

Titan, foil, thickness 0.25 mm, 99.99% trace metals basis

266035

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Titan, wire, diam. 1.0 mm, 99.99% trace metals basis

305812

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Titan, 5-10 mm, ≥99.99% trace metals basis (purity exclusive of Na and K content)

348864

Sigma-Aldrich

Titan, wire, diam. 0.5 mm, 99.99% trace metals basis

267902

Sigma-Aldrich

Titan, wire, diam. 0.81 mm, 99.7% trace metals basis

GF31127712

Titan, rod, 10mm, diameter 50mm, 99.99+%

GF14990935

Titan, tube, 1000mm, outside diameter 10.3mm, inside diameter 8.7mm, wall thickness 0.8mm, annealed, 99.6+%

GF46592949

Titan, wire, straight, 1000mm, diameter 1.0mm, as drawn, 99.6+%

433667

Sigma-Aldrich

Titan, evaporation slug, diam. × L 6.3 mm × 6.3 mm, ≥99.99% trace metals basis

GF62977540

Titan, tube, 200mm, outside diameter 2.03mm, inside diameter 1.63mm, wall thickness 0.2mm, annealed, 99.6+%

GF13900205

Titan, tube, 100mm, outside diameter 0.51mm, inside diameter 0.35mm, wall thickness 0.08mm, annealed, 99.6+%

GF49264713

Titan, tube, 200mm, outside diameter 1.6mm, inside diameter 1.2mm, wall thickness 0.2mm, hard, 99.6+%

GF86399106

Titan, tube, 500mm, outside diameter 1.6mm, inside diameter 1.2mm, wall thickness 0.2mm, hard, 99.6+%

GF43519945

Titan, wire reel, 2m, diameter 1.0mm, as drawn, 99.99+%

GF95731960

Titan, tube, 500mm, outside diameter 3.0mm, inside diameter 1.5mm, wall thickness 0.75mm, annealed, 99.6+%

GF52005596

Titan, tube, 500mm, outside diameter 9.5mm, inside diameter 8.2mm, wall thickness 0.65mm, annealed, 99.6+%

GF04311638

Titan, rod, 100mm, diameter 6mm, annealed, 99.6+%