Abstract

GARABANO, German; MANA PASTRIAN, Diego S  and  DEL SEL, Hernan. Revisiones de cadera en defectos oseos femorales Paprosky II y IIIA: Utilizacion de protesis no cementada, modular, de fijacion proximal y anclaje distal. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2016, vol.81, n.2, pp.115-121. ISSN 1852-7434.

Background: The purpose of this retrospective analysis was to observe the outcomes of a modular hip system in revision total hip arthroplasty with Paprosky types II and IIIA femoral bone defects, evaluating their performance, offset restoration and leg length discrepancy correction. Methods: Twenty-two revision total hip arthroplasties were analyzed in 12 women and 10 men (average age 62.38 years). The average follow-up was 62 months. Femoral stems S-ROMR (Depuy, Johnson & Johnson) were used. Paprosky femoral bone deficit were 15 types II and 7 IIIA. Clinical evaluation was performed using the Harris Hip Score, while Engh classification was used for stem fixation. Offset restoration, leg length discrepancy (a difference <5 mm was considered correct) and hip stability were evaluated radiographically. Results: Offset was properly restored in 16 (72.3%) cases and the leg length was matched in 15 (68.2%). There was a single stem subsidence and according to Engh classification, proximal bone ingrowth fixation was obtained in 17 (77.27%) patients. There were 7 (31.8%) complications: two dislocations that required revision, four intraoperative fractures and a lateral popliteal nerve paresis. Conclusions: S-ROMR modular system seems to be a valid alternative to solve a complex problem. Its versatility allows to optimize hip stability, leg length equalization and offset restoration in revision total hip arthroplasty, showing an acceptable complication rate.

Keywords : Revision; Total hip arthroplasty; Modular uncemented femoral stem; Proximal fixation; Offset; Leg length discrepancy; Joint stability.

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