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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
UPDATES ON HIP ARTHROPLASTY 102nd CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Brescia September 9-10, 2005
NEW TECHNOLOGIES, MODERN INSTRUMENTARIUM IN ARTHROPLASTIC SURGERY
Minerva Ortopedica e Traumatologica 2005 August;56(4):215-23
Techniques and strumentation for hip redo prosthesis: algorithm approach
Del Sasso L., Cavenago C., Mazza E., Marchese M., Di Mento L.
U.O. di Ortopedia e Traumatologia Dipartimento di Chirurgia Azienda Ospedaliera S. Anna, Como
Aim. Hip revision surgery is a complex and difficult matter, strongly depending on preoperative planning, surgeon’s experience, and instruments availability. The authors present the most affirmed techniques and instrumentations available to safely perform the femoral stem revision.
Methods. From 1990 to 2003, 434 patients have been operated on with femoral stem removal and substitution. They presented with an aseptic loosening of the femoral stem, and have been treated by means of different surgical techniques. Septic loosenings have been excluded from the present study. Three-hundred and forty-seven patients (79.95%) have been followed-up for an average period of 5 years.
Results. The survival of the new stem was confirmed in 80% of cases at 5 years follow-up. Harris hip score (HHS) was improved by an average of 32 points.
Conclusion. The authors trust does not exist a single technique applicable in every case, or preferable over the others. The algorithmic approach (bone defect classification, preoperative planning, surgical approach, loosened implant removal, bone and soft-tissue assessment, reconstruction, and post-operative management) has facilitated management of difficult cases, making the procedure and outcome more predictable. In this way, procedures can be performed in a streamlined fashion that benefits the patient, surgeon and staff.