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. 2021 Apr 5:8:181-187.
doi: 10.1016/j.artd.2021.02.017. eCollection 2021 Apr.

Medium Term Radiographic and Clinical Outcomes Using a Modular Tapered Hip Revision Implant

Affiliations

Medium Term Radiographic and Clinical Outcomes Using a Modular Tapered Hip Revision Implant

Gihan Jayasinghe et al. Arthroplast Today. .

Abstract

Background: The rate of revision hip arthroplasty surgery is rising. Surgeons must use implants with proven outcomes to help overcome the technical challenges faced during revision surgery. However, outcome studies using these implants are limited. The aim of this study is to investigate the radiographic and clinical outcomes of the Stryker Restoration stem, the most commonly used hip revision stem in the United Kingdom (UK).

Methods: A retrospective review of a single surgeon case series was performed. Immediate postoperative radiographs were analyzed for offset and leg length discrepancy. Radiographic evidence of subsidence was assessed using follow-up radiographs. Kaplan-Meier survival analysis was applied using explantation and reoperation as endpoints. Patient-reported outcomes were measured using the Oxford Hip Score and EQ-5D-5L.

Results: One hundred ninety-eight cases were identified. Mean follow-up duration was 51.8 months (range: 24-121). Stem survival during this period was 98%. Reoperation for any reason was 13%. Mean subsidence was 4.18 mm. Analysis of variance testing showed no difference in mean subsidence between revision indications. Mean offset and leg length discrepancies were measured at 4.5 mm and 4.3 mm, respectively. The mean Oxford Hip Score for participants was 27.6.

Conclusions: This series demonstrates excellent implant survival, with radiographic parameters for reconstruction and subsidence levels comparable to those in the existing literature. The tapered modular hip revision stem provides surgeons with the intraoperative flexibility to overcome some of the anatomical difficulties encountered during revision surgery; this is reflected in the radiographic and clinical outcomes of the cohort in this study.

Keywords: Outcomes; PROMS; Revision hip arthroplasty; Survival; Tapered modular stems.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curve using removal of stem as an endpoint. Censored data indicated by crosses.
Figure 2
Figure 2
Kaplan-Meier survival curve using return to theatre for any cause as an endpoint. Censored data indicated by crosses.
Figure 3
Figure 3
EQ-5D-5L scores for each domain questioned.

References

    1. Patel A., Pavlou G., Mújica-Mota R., Toms A. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J. 2015;97(8):1076. - PubMed
    1. Sheth N.P., Nelson C.L., Springer B.D., Fehring T.K., Paprosky W.G. Acetabular bone loss in revision total hip arthroplasty: evaluation and management. J Am Acad Orthop Surg. 2013;21(3):128. - PubMed
    1. Weeden S.H., Paprosky W.G. Minimal 11-year follow-up of extensively porouscoated stems in femoral revision total hip arthroplasty. J Arthroplasty. 2002;17(4 Suppl 1):134. - PubMed
    1. Stryker 2009. https://www.strykermeded.com/media/2009/restoration-modular-cone-conical... [Accessed 1 June 2018]
    1. NJR 2017. http://www.njrcentre.org.uk/njrcentre/Reports,PublicationsandMinutes/Ann... [Accessed 1 June 2018]

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