Abd-Allah El Ashmawy1, Hazem A H Hosny2,3, Ahmed El-Bakoury2,3, Rathan Yarlagadda3, Jonathan Keenan3. 1. Department of Trauma and Orthopaedic Surgery, University of Alexandria, Alexandria, Egypt. Dr.3ashmawy@gmail.com. 2. Department of Trauma and Orthopaedic Surgery, University of Alexandria, Alexandria, Egypt. 3. Department of Orthopaedic Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Abstract
BACKGROUND: Modular design in revision hip surgery allows some flexibility intra-operatively to address leg length discrepancy, version, and offset while allowing the surgeon to bypass a deficient proximal femur and achieve axial and rotational stability distally. The purpose of this study was to analyze the mid-term to long-term survival and clinical and radiological outcomes using a conical fluted stem and a cone-shaped hydroxyapatite-coated proximal body "The Cone-Conical modular system (Stryker)" in revision hip surgery. METHODS: We retrospectively reviewed all the patients who underwent hip revision surgery using Cone-Conical modular system between January 2006 and January 2015 at our institution. Seventy patients (72 hips) were included with a mean age of 71.3 years. We had a mean follow-up period of 8.6 years (range 5-15). All patients had a minimum follow-up of five years. A Kaplan-Meier analysis was used to determine the survival of the implant. Functional outcomes were assessed using Oxford Hip Score. Plain radiographs were performed to assess implant fixation and osseointegration. RESULTS: The mean OHS improved significantly from 12 pre-operatively to 34 at the final follow-up (P < .001). The Cone-Conical system survivorship for aseptic loosening as an end point was 100%. The all-cause survivorship was 97.2%. Two hips had revisions for recurrence of infection. CONCLUSIONS: The Cone-Conical femoral modular revision system has demonstrated excellent mid-term to long-term clinical and radiographic results with low failure rate and minimal complications. Longer-term follow-up would be of value to assess the ongoing survival of this implant.
BACKGROUND: Modular design in revision hip surgery allows some flexibility intra-operatively to address leg length discrepancy, version, and offset while allowing the surgeon to bypass a deficient proximal femur and achieve axial and rotational stability distally. The purpose of this study was to analyze the mid-term to long-term survival and clinical and radiological outcomes using a conical fluted stem and a cone-shaped hydroxyapatite-coated proximal body "The Cone-Conical modular system (Stryker)" in revision hip surgery. METHODS: We retrospectively reviewed all the patients who underwent hip revision surgery using Cone-Conical modular system between January 2006 and January 2015 at our institution. Seventy patients (72 hips) were included with a mean age of 71.3 years. We had a mean follow-up period of 8.6 years (range 5-15). All patients had a minimum follow-up of five years. A Kaplan-Meier analysis was used to determine the survival of the implant. Functional outcomes were assessed using Oxford Hip Score. Plain radiographs were performed to assess implant fixation and osseointegration. RESULTS: The mean OHS improved significantly from 12 pre-operatively to 34 at the final follow-up (P < .001). The Cone-Conical system survivorship for aseptic loosening as an end point was 100%. The all-cause survivorship was 97.2%. Two hips had revisions for recurrence of infection. CONCLUSIONS: The Cone-Conical femoral modular revision system has demonstrated excellent mid-term to long-term clinical and radiographic results with low failure rate and minimal complications. Longer-term follow-up would be of value to assess the ongoing survival of this implant.
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