Revision total hip arthroplasty after removal of a fractured well-fixed extensively porous-coated femoral component using a trephine

The Bone & Joint Journal
Derek F AmanatullahRobert T Trousdale

Abstract

When fracture of an extensively porous-coated femoral component occurs, its removal at revision total hip arthroplasty (THA) may require a femoral osteotomy and the use of a trephine. The remaining cortical bone after using the trephine may develop thermally induced necrosis. A retrospective review identified 11 fractured, well-fixed, uncemented, extensively porous-coated femoral components requiring removal using a trephine with a minimum of two years of follow-up. The mean time to failure was 4.6 years (1.7 to 9.1, standard deviation (sd) 2.3). These were revised using a larger extensively porous coated component, fluted tapered modular component, a proximally coated modular component, or a proximal femoral replacement. The mean clinical follow-up after revision THA was 4.9 years (2 to 22, sd 3.1). The mean diameter of the femoral component increased from 12.7 mm (sd 1.9) to 16.2 mm (sd 3.4; p > 0.001). Two revision components had radiographic evidence of subsidence that remained radiographically stable at final follow-up. The most common post-operative complication was instability affecting six patients (54.5%) on at least one occasion. A total of four patients (36.4%) required further revision: three for instability and one...Continue Reading

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Citations

Mar 30, 2010·The Journal of Arthroplasty·Vineet SharmaChitranjan S Ranawat
Jun 10, 2008·The Journal of Arthroplasty·Imran AnwarSalah Atrah
Mar 28, 2021·Journal of Orthopaedic Surgery and Research·Peter WahlEmanuel Gautier
Aug 21, 2021·Journal of the Mechanical Behavior of Biomedical Materials·Christopher Butler RansohoffPeter Wahl

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