Background: The aim of this study was to review the results of the use of a cemented, standard length, taper-slip femoral component at second stage following an extended trochanteric osteotomy (ETO).
Methods: We reviewed prospectively collected data from the hospital arthroplasty database, identifying and reviewing all patients who had undergone an ETO at first-stage revision for infection, who had subsequently undergone second-stage reimplantation.
Results: Over 17 years, 99 patients underwent 102 2-stage procedures with ETO at first stage, with a mean follow-up of 5.5 years; 70 of 102 patients received a standard prosthesis following ETO union and 32 of 102 patients received a long-stem prosthesis at second stage because of deficiencies in proximal femoral bone stock. There was a significant difference in the Paprosky classification between the 2 groups (P < .0001); 77% of the standard group and 52% of the long-stem group had no complications. A significant complication (infection, fracture, or dislocation) was observed in 12% patients in the standard group and 16% patients in the long-stem group. A number of radiographs were independently reviewed to assess for ETO union and complications and an intraclass correlation of 0.84 (P < .0001) was observed.
Conclusion: A standard femoral prosthesis can be implanted at second stage following ETO union for Paprosky type I and some type II femora. There is no greater risk of complications, and distal bone stock is preserved for potential revision surgery in the future.
Keywords: 2-stage revision; Paprosky classification; extended trochanteric osteotomy; long stem femoral prosthesis; periprosthetic joint infection; standard femoral prosthesis.
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