Cementless, modular, distally fixed stem in hip revision arthroplasty: a single-center study of 132 consecutive hips

Eur J Orthop Surg Traumatol. 2018 Jan;28(1):45-50. doi: 10.1007/s00590-017-2013-x. Epub 2017 Jul 12.

Abstract

Purpose: The use of cementless, modular, distally fixed stem in hip revision arthroplasty has increased during the last decades. We aimed to analyze the early and late postoperative complications, re-operation rate, and survival rate of the MP stem operated at our county hospital with relatively limited caseload.

Methods: In this retrospective study, we included 132 hips operated with MP stem between January 2007-2014. An independent observer reviewed patients' medical records in July 2015 (18-102 months postoperatively, median 52.5) to collect the following data: age, sex, American Society of Anesthesiologists (ASA) class, body mass index, indication of revision, type of operation, early and late complications, re-operation rate, and mortality during study period.

Results: The commonest indication for MP stem operation was aseptic loosening (72%). We found early and late postoperative complications in 29% of cases. The most common complication was prosthetic dislocation (8%), followed by intra-operative peri-prosthetic fracture (5%). The commonest indication for MP re-operation was soft tissue revision for infection (7%) followed by closed reduction for prosthetic dislocation (6%). We found no correlation between the age, sex, ASA class, and type of operation and the re-operation risk. Only one prosthesis was extracted giving a survival rate for 99% for the study period.

Conclusion: This study showed good results of the MP prosthesis with reasonable complication and re-operation rates and negligible extraction rate, indicating the good performance of this implant even when used in the setting of a county hospital with limited caseload.

Keywords: Cementless stem; Complication; Distally fixed; Hip revision; Outcome; Survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / instrumentation*
  • Arthroplasty, Replacement, Hip / methods
  • Female
  • Femoral Fractures / etiology
  • Femoral Fractures / surgery
  • Hip Dislocation / etiology
  • Hip Dislocation / surgery
  • Hospitals, Low-Volume
  • Humans
  • Intraoperative Complications / surgery
  • Male
  • Middle Aged
  • Periprosthetic Fractures / etiology
  • Periprosthetic Fractures / surgery
  • Prosthesis Failure*
  • Reoperation*
  • Retrospective Studies
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / surgery
  • Survival Rate