Influence of Technique With Distally Fixed Modular Stems in Revision Total Hip Arthroplasty |
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Authors: | Preetesh D. Patel Alison K. Klika Trevor G. Murray Karim A. Elsharkawy Viktor E. Krebs Wael K. Barsoum |
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Affiliation: | ? Department of Orthopedic Surgery, Cleveland Clinic Florida, Weston, Florida;† Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio |
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Abstract: | Distally fixed modular implants have seen a recent increase in use, to manage proximal femoral bone loss often encountered during revision total hip arthroplasty (THA). Forty-three distally fixed modular stems implanted at our institution between 1999 and 2006 were clinically and radiographically reviewed. These patients had either a minimum 2-year follow-up (average, 2.4 years; range, 2-5.6 years) or failure (ie, explant or rerevision required). Eleven stems subsided, and 4 were rerevised (n = 4), for a rate of 9.3%. All revised stems were radiographically undersized, emphasizing the importance of the technique. Although being a valuable option in revision THA, these stems are not free of complications. The high rate of subsidence encountered in our early experience shows that there is a learning curve. This complication is preventable by avoiding undersizing. |
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Keywords: | total hip arthroplasty revision modularity distal fixation subsidence undersizing |
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