Distal Interlocking Screws With a Modular Revision Stem for Revision Total Hip Arthroplasty in Severe Bone Defects

A prospective study of 15 patients was designed to examine whether the modular cementless revision stem (Revitan curved; Zimmer GmbH, Winterthur, Switzerland) is suitable for stem revisions with a defective isthmus when distal interlocking screws are also used for fixation. During a follow-up period of 35.4 ± 11.4 months (24-70 months), there was one stem loosening with screw breakage in a case of a stem that was too thin. According to Engh et al, bony ingrowth fixation of the stem occurred in 12 cases and stable fibrous fixation in 2 cases. The Harris Hip Score rose continuously from 44.7 ± 12.9 points preoperatively to 75 ± 10 points at 24 months. This concept of additional stem fixation with distal interlocking screws represents a useful treatment option for revision arthroplasty in rare cases of a defective isthmus.