AIM: THR is one of the most successful principles in orthopaedics. With the increasing number of primary THR more and more revision arthroplasties of the hip are necessary. Many factors including loss of bone stock, instability of the joint, infection, fractures, removal of the implant or cement mantles are a challenging condition for the surgeon. Many approaches and techniques for the removal of cement mantles are published. We prefer the intrafemoral approach with an distal vascularized femoral window. METHOD: We want to describe our surgical technique and report the short term results of 45 revision arthroplasties of the hip using the uncemented modular titanium MRP stem. Mean follow-up was 2.6 years (min:1 year, max: 7 years). RESULTS: Mean Harris hip score increased from preoperative 53,2 (16 - 89) to postoperative 90.4 (35 - 100) points. We could find remodelling of the bone and spontaneous refill of bony defects in all cases. After 14 weeks we could find bony consolidation of the femoral window. The Trendelenburg sign was positive preoperatively in 26 cases, postoperatively in 11 cases. Just one single dislocation of the revised hip occurred postoperatively. CONCLUSION: The intrafemoral approach with distal vascularized femoral fenestration is a mild approach without further weakening of the pelvitrochanteric muscles. Removal of cement mantles is possible without any problems. Using the vascularized technique of the femoral fenestration prompt bony consolidation can be achieved.
AIM: THR is one of the most successful principles in orthopaedics. With the increasing number of primary THR more and more revision arthroplasties of the hip are necessary. Many factors including loss of bone stock, instability of the joint, infection, fractures, removal of the implant or cement mantles are a challenging condition for the surgeon. Many approaches and techniques for the removal of cement mantles are published. We prefer the intrafemoral approach with an distal vascularized femoral window. METHOD: We want to describe our surgical technique and report the short term results of 45 revision arthroplasties of the hip using the uncemented modular titanium MRP stem. Mean follow-up was 2.6 years (min:1 year, max: 7 years). RESULTS: Mean Harris hip score increased from preoperative 53,2 (16 - 89) to postoperative 90.4 (35 - 100) points. We could find remodelling of the bone and spontaneous refill of bony defects in all cases. After 14 weeks we could find bony consolidation of the femoral window. The Trendelenburg sign was positive preoperatively in 26 cases, postoperatively in 11 cases. Just one single dislocation of the revised hip occurred postoperatively. CONCLUSION: The intrafemoral approach with distal vascularized femoral fenestration is a mild approach without further weakening of the pelvitrochanteric muscles. Removal of cement mantles is possible without any problems. Using the vascularized technique of the femoral fenestration prompt bony consolidation can be achieved.