Study finds, Role for Modern Primary Cementless Femoral Stem
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Tapered proximally porous-coated “primary” femoral stems may be a choice in revision complete hip arthroplasty (THA) cases with preserved femoral metaphyseal bone. The aim of this study was to see how patients with Paprosky I or II femoral bone loss fared after undergoing revision THA with either a primary metaphyseal-engaging cementless stem or a revision diaphyseal-engaging stem.

This study looked at 70 patients who had Paprosky I or II femoral bone loss and had femoral revision surgery. The results of 35 patients who had their femoral stems replaced with a primary cementless femoral stem were compared to 35 patients who had their femoral stems replaced with a revision diaphyseal-engaging stem. In terms of age, gender, BMI, and ASA, the groups were similar. Over the course of 2.9 years, clinical and radiographic results, as well as complications, were compared (SD 1.4).

Results:
--Revision THA was most commonly performed for periprosthetic joint infection (N=27).

--The groups were similar with regards to Paprosky femoral classification, length of stay, discharge disposition, operative time, and complications.

--There were no significant differences between primary and revision femoral stem subsidence (0.12 vs. 0.75mm), leg length discrepancy (2.3 vs. 4.05mm), and HOOS Jr scores (73.1 [SD 21.1] vs 62.8 [SD 21.7]).

--No patient underwent additional revision surgery involving the femoral component.

Finally, when the proximal femoral metaphyseal bone is preserved, revision hip arthroplasty with modern primary cementless femoral stems is a viable alternative. The results are comparable to those of revision stems and may even be superior.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0883540321004149?dgcid=rss_sd_all
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