Dataset Information

Endofemoral Shooting Technique for Removing Well-fixed Cementless Stems.

ABSTRACT:

Background

The removal of a well-fixed cementless stem poses technical challenges. The aim of this study was to evaluate the outcomes of our endofemoral extraction technique established in 2001.

Methods

Between January 2001 and December 2016, 118 consecutive revisions following bipolar or total hip arthroplasty, which required cementless femoral stem removal, were performed at our institution. This retrospective study evaluated 106 patients (108 hips) who were followed up for a mean of 9.2 years (range, 5-20 years). The patients included 15 men and 91 women with a mean age of 65 years (range, 33-87 years). Endofemoral extracted stem removal was performed as follows. Multiple Kirschner wires were sequentially inserted into the interface between the implant and cortical bone, after which the implant was detached using a thin chisel. After the cementless stem was removed, it was replaced with a cemented stem using an autograft, as needed. Radiological loosening of the femoral stem was defined as definite or probable loosening, based on the criteria of Harris et al. Prosthesis survival was analyzed using the Kaplan-Meier method, with the endpoint set as repeat revision surgery for stem loosening or femoral fracture.

Results

Re-revision surgery was performed in 7 hips. Stem loosening was observed in 4 hips, and the mean subsidence was 0.3 mm (0-3 mm). The 10-year survival rate was 97.7% (95% confidence interval, 93.2-100).

Conclusions

Our technique for removing well-fixed cementless stems yielded successful results.

SUBMITTER: Oe K

PROVIDER: S-EPMC9399389 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Endofemoral Shooting Technique for Removing Well-fixed Cementless Stems.

Oe Kenichi K Iida Hirokazu H Toyoda Takashi T Nakamura Tomohisa T Okamoto Naofumi N Saito Takanori T

Arthroplasty today 20220815

<h4>Background</h4>The removal of a well-fixed cementless stem poses technical challenges. The aim of this study was to evaluate the outcomes of our endofemoral extraction technique established in 2001.<h4>Methods</h4>Between January 2001 and December 2016, 118 consecutive revisions following bipolar or total hip arthroplasty, which required cementless femoral stem removal, were performed at our institution. This retrospective study evaluated 106 patients (108 hips) who were followed up for a me ...[more]

PMID: 36032794

Similar Datasets

Project description:Background and purpose - Short-term experimental studies have confirmed that there is superior fixation of cementless implants inserted with compaction compared to broaching of the cancellous bone. Patients and methods - 1-stage, bilateral primary THA was performed in 28 patients between May 2001 and September 2007. The patients were randomized to femoral bone preparation with broaching on 1 side and compaction on the other side. 8 patients declined to attend the postoperative follow-up, leaving 20 patients (13 male) with a mean age of 58 (36-70) years for evaluation. The patients were followed with radiostereometric analysis (RSA) at baseline, at 6 and 12 weeks, and at 1, 2, and 5 years, and measurements of periprosthetic bone mineral density (BMD) at baseline and at 1, 2, and 5 years. The subjective part of the Harris hip score (HHS) and details of complications throughout the observation period were obtained at a mean interval of 6.3 (3.0-9.5) years after surgery. Results - Femoral stems in the compaction group had a higher degree of medio-lateral migration (0.21 mm, 95% CI: 0.03-0.40) than femoral stems in the broaching group at 5 years (p = 0.02). No other significant differences in translations or rotations were found between the 2 surgical techniques at 2 years (p > 0.4) and 5 years (p > 0.7) postoperatively. There were no individual stems with continuous migration. Periprosthetic BMD in the 7 Gruen zones was similar at 2 years and at 5 years. Intraoperative femoral fractures occurred in 2 of 20 compacted hips, but there were none in the 20 broached hips. The HHS and dislocations were similar in the 2 groups at 6.3 (3.0-9.5) years after surgery. Interpretation - Bone compaction as a surgical technique with the Bi-Metric stem did not show the superior outcomes expected compared to conventional broaching. Furthermore, 2 periprosthetic fractures occurred using the compaction technique, so we cannot recommend compaction for insertion of the cementless Bi-Metric stem.

Dataset Information

Endofemoral Shooting Technique for Removing Well-fixed Cementless Stems.

Background

Methods

Results

Conclusions

Publications

Endofemoral Shooting Technique for Removing Well-fixed Cementless Stems.

Similar Datasets

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