Clinical Application Of Un-cemented Distal Fixation Stem For Elderly Patients Of Non-infective In The Revision Of Femoral Prosthesis Of Total Hip Arthroplasty

ObjectiveTo evaluate the clinical outcomes of the application of un-cemented distal fixation stem for elderly patients of non-infective in the revision of femoral prosthesis of total hip arthroplasty.MethodFrom July 2005 to October 2010,15 patients aged over 70 years with aseptic loosening femoral stem were revised including 14 males and 11 females, the average age is 76(from 70 to 85).11 right and 14 left sides.12 cases were after the surgery of artificial replacement of femoral head,10 cases after total hip replacement,3 cases of periprosthetic femoral fracture. Based on Paprosky classification system, type I were 3 cases, type II were 13 cases, type IIIA were 7 cases, type â…¢B were 2 cases. Femoral stems for revision include MP (Link), Solution (Depuy), MH (Biomet) Enchelon calcar replacement system. The patients were followed up postoperatively to observe the Harris score, clinical and radiological results.ResultsAll cases were followed up for mean 42 months (from 18 to 65). The average Harris hip score increased from 38 to 87.The excellent or good rate of post-surgery was above 90%.All prosthesis were initially stable, no infection, dislocation and deep venous thrombosis after revision. All patients are in good condition without assistance, two of them were minor claudication, the radiographs after surgery showed good location of implants, increased bone density and thickness around the prosthesis and no femoral stem loosening or subsidence occurred.ConclusionReliable axial and anti-rotational stability can be achieved with the application of un-cemented distal fixation stem. It is especially appropriate for the revision surgery in elderly patients which there bone defect are less serious than Paprosky IV with good short and medium term clinical results.