ABSTRACT
PURPOSE: To evaluate the clinical and radiological changes of femoral revision with the Wagner SL stem. MATERIALS AND METHODS: 21 femoral revisions were performed in 21 patients (16 males and 5 females; mean age 58.9 years) between June 1997 and July 2005, utilizing the Wagner SL stem. The follow-up period was a mean of 31 months (range 25-84 months). Causes of revision included aseptic loosening (14 cases), periprosthetic fracture (4 cases), recurrent total hip dislocation (2 cases), and neglected bipolar hip dislocation (1 case). Greater trochanteric osteotomy was performed in 10 cases, and extended trochanteric osteotomy was performed in 6 cases. Clinical results were assessed using Harris hip score. Radiographic parameters such as stem subsidence, calcar atrophy, and stressshielding were also assessed. RESULTS: The mean Harris hip score improved from 45.7 to 91.3. There was no removal of the implanted Wagner stem. One case of nonunion of the greater trochanter was treated by fixation with Dall-Miles cables and a trochanteric plate. There was one case of limb shortening of 2 cm. CONCLUSION: The Wagner SL stem provided immediate stability and allowed early weight-bearing. Bony regeneration around the stem was achieved without resorting to a bone graft.
Subject(s)
Humans , Male , Arthroplasty, Replacement, Hip , Atrophy , Extremities , Femur , Follow-Up Studies , Health Resorts , Hip , Hip Dislocation , Osteotomy , Periprosthetic Fractures , Regeneration , Transplants , Weight-BearingABSTRACT
PURPOSE: To evaluate the results of revision total hip arthroplasty using a Wagner SL revision stem. MATERIALS AND METHODS: This study reviewed 56 revisions of the femoral component performed using a Wagner stem in 55 patients between 1992 and 2001. The mean age of the patients at the time of the revision was 50 years. The mean follow up duration was 8.4 years (range, 5 to 12.5 years). The indication for revision was aseptic loosening in fifty-two hips, septic loosening in two and periprosthetic fractures in two. The pre-revisional femoral defects were classified according to the Paprosky classification system. A clinical evaluation and radiological assessment were performed. RESULTS: The mean Harris hip score improved from 47 points preoperatively to 87 points at the latest follow-up. There were 5, 20, 22 and 9 hips of type I, II, IIIA and IIIB according to the Paprosky classification system. Fifty two hips (93%) showed stable stems at the latest follow-up radiographs. The mean vertical subsidence of the stem was 6.2 mm (range, 0 to 21 mm). Severe progressive vertical subsidence in three hips and an infection in one occurred requiring repeat revision. CONCLUSION: For severe proximal femoral bone loss, the conical femoral revision stem with a fully grit-blasted surface produced satisfactory results with distal press-fit fixation. We can expect a decrease in the rate of mechanical failure rate of the stem by reducing the subsidence derived from the stem design itself.
ABSTRACT
PURPOSE: The aim of this study was to see the results of total hip arthroplasty revision using Wagner femoral revision stem. MATERIALS AND METHODS: From January 1994 and December 1998, we implanted to twenty-three Wagner revision stems in 22 patient (23 cases). The patients'average age was 54 years and the average follow-up time was 48 months. The causes of the revision were as follows: aseptic loosening (18 cases), periprosthetic fractures with loosening (4 cases), and septic loosening (1 case). RESULTS: The preoperative Harris hip score was 47 points, and this improved to 90.5 points postoperatively. There were 3 cases of inguinal pain, 2 cases of thigh pain, 3 cases of leg length discrepancy, and one case of subsidence of stem exceeding more than 5 mm. Postoperative complications included 2 cases of hip posterior dislocation, and 2 cases of heterotopic ossification. CONCLUSION: No patient required re-revision surgery to treat stem loosening or other problems. The results of the operations were excellent. However, we had difficulty selecting the optimal stem size with respect to preventing subsidence problems.