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- Title
Long-term results of custom cementless-stem total hip arthroplasty performed in hip fusion.
- Authors
Flecher, Xavier; Ollivier, Matthieu; Maman, Pascal; Pesenti, Sébastien; Parratte, Sébastien; Argenson, Jean-Noël
- Abstract
<bold>Introduction: </bold>Due to complex anatomical considerations, results of cementless-stem total hip arthroplasty (THA) in hip fusion remain controversial compared with conventional THA. We therefore aimed to analyse 3D anatomy of the fused hip based on pre-operative computed tomography (CT) scans, functional outcomes based on the Harris Hip Score (HHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS), modifications of hip anatomy based on post-operative standardised radiography, and determine complication rate and long-term survival based on Kaplan-Meier analysis.<bold>Methods: </bold>We retrospectively studied 23 hips that underwent conversion of a fused hip to THA using a 3D CT scan-based custom titanium (Ti alloy hypoxyapetite (HA)-coated stem. The mean follow-up was 15 (9-22) years. Femur anteversion ranged from -29° to 80°.<bold>Results: </bold>HHS improved from 59 to 89 points and average range of motion (ROM) was 88° for flexion. Back pain decreased in 62%, and knee pain decreased in 42%. The mean post-operative leg-length discrepancy was 7.8 mm. No intra-operative complications occurred. One aseptic stem loosening for mechanical failure was observed. The Kaplan-Meier survivorship considering revision for any reasons as the end point was 95.6% [95% confidence interval (CI) 92.4-98.8] at 15 years.<bold>Conclusion: </bold>Custom cementless stems may be an interesting solution to address the particular anatomical features of hip fusion at the time of THA, with an excellent survival rate at 15 years.
- Subjects
TOTAL hip replacement; HIP surgery; ORTHOPEDIC surgery; SURGICAL complications; COMPUTED tomography; POSTOPERATIVE care; ARTHRODESIS; ARTIFICIAL joints; RANGE of motion of joints; COMPLICATIONS of prosthesis; TITANIUM; THREE-dimensional imaging; TREATMENT effectiveness; RETROSPECTIVE studies; KAPLAN-Meier estimator
- Publication
International Orthopaedics, 2018, Vol 42, Issue 6, p1259
- ISSN
0341-2695
- Publication type
journal article
- DOI
10.1007/s00264-018-3762-9