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Minimum ten-year results in revision total hip arthroplasty using titanium fully porous long stem

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Abstract

Purpose

The fully porous long stem could be used for diaphyseal locking and achieve bypass fixation in revision total hip arthroplasty (THA). This study evaluated long-term results for fully porous long stems made of titanium alloy in revision THA.

Methods

Between 2003 and 2010, 45 consecutive femoral revisions were performed using fully porous long stems. Thirty-eight hips had complete clinical and radiographic data for a mean of 13.8 years (range, 10–16.7 years). Femoral bone loss was Paprosky type II in 14 hips, type IIIA in 18 hips, and type IIIB in six hips. Clinical results were analyzed using the Merle d’Aubigné and Postel scoring system. Femoral stress shielding was graded. Radiological loosening of the femoral component was evaluated. Kaplan-Meier survival analysis was performed with revision for any reason as the end-point.

Results

Mean Merle d’Aubigné and Postel score improved significantly from 10.7 before revision to 14.5 at latest follow-up (p < 0.001). Third-degree stress shielding was found in seven hips, and fourth degree in 11 hips. Radiological femoral loosening occurred in one hip, which was revised. Another hip was revised for stem fracture. Kaplan-Meier cumulative survival rate was 94.7% at both ten and 15 years.

Conclusion

Although stress shielding is a concern with fully porous stems, this stem was useful in revision THA and provided satisfactory long-term results in hips with Paprosky types II, IIIA, and IIIB.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan

    Masahiro Hasegawa, Shine Tone, Yohei Naito, Hiroki Wakabayashi & Akihiro Sudo

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  1. Masahiro Hasegawa
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  2. Shine Tone
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  3. Yohei Naito
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  4. Hiroki Wakabayashi
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  5. Akihiro Sudo
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Contributions

MH was the main investigator and wrote the manuscript. ST, YN, and WH helped with data analysis. AS helped with the interpretation of the data and results.

Corresponding author

Correspondence to Masahiro Hasegawa.

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This study was approved by the ethics committee of Mie University (H2018-083).

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Informed consent was obtained from all individual participants included in the study.

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Written informed consent to publish this information was obtained from study participants.

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The authors declare no competing interests.

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Hasegawa, M., Tone, S., Naito, Y. et al. Minimum ten-year results in revision total hip arthroplasty using titanium fully porous long stem. International Orthopaedics (SICOT) 45, 1727–1733 (2021). https://doi.org/10.1007/s00264-021-05030-4

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