Extensively Porous Coated Stems in Femoral Revision in Total Hip Arthroplasty- Can solve every situation?

초록

Extensively Porous Coated Stem -Can solve every situation?- The goals of cementless femoral revision are to achieve axial and rotational stability by maximizing canal fill at the time of implantation and to reproduce mormal hip biomrechanics. The problems encoutered during femoral revision are non-supporting proximal femur, lack of cancellous bone for recementing, fragile and osteolytic great trochanter. We reported on minimum 3 years clinical and radiograpic fo;;ow-up of 31 patients with extensively porous-coated femoral components. With range of follow-up of 36 to 93 months and mean of 50 months, 100% survivorship was reported. Clnically, the average Harris hip score improved from a preoperative score of 69 pints to 93 points postoperatively. Seventy-eight percents of hip had radiographic evidence of a bone-ingrowth prosthesis and 22 % had evidence of stable fibrous fixation. there was no unstable fixation on radiographs. Stress shieding were shown in thirty patients mild, and in one patient moderate. The complications after revision surgery were one DVT, three ectopic ossification, one great trochater fracture, and two nonunion of extened trochamteric osteotomy site. In the presene of bone loss in the proximal metaphyseal region of the femur, fixation of femoral component is predictable when optimizing prosthetic-bone fit in the diaphyseal region of femur using an extensively porous coated femoral component.