Observational study of a new modular femoral revision system  

作　　者：Karen Dyreborg Michael Mørk Petersen Sidse Schwartz Balle Anne Grete Kjersgaard Søren Solgaard 

机构地区：[1]Department of Orthopaedic Surgery,Herlev-Gentofte Hospital,2900 Hellerup,Denmark [2]Department of Orthopaedic Surgery,Rigshospitalet,2100 København,Denmark [3]Department of Diagnostic Radiology,Herlev-Gentofte Hospital,2900 Hellerup,Denmark

出　　处：《World Journal of Orthopedics》2020年第3期167-176,共10页世界骨科杂志（英文版）

基　　金：Supported by the Zimmer Biomet,No.C004287

摘　　要：BACKGROUND The uncemented ArcosTM Modular Femoral Revision System(ARCOS)is a new comprehensive,press-fit revision design.The modular design offers a wide range of possible combinations to accommodate different variations of anatomy and bone stock.The ARCOS is made by a proximal body and a distal stem.As probably the only ones worldwide we predominantly use a combination of body and stem which supports proximal fixation and load,since this mimics the concept of the primary total hip arthroplasty with proximal weight-bearing,leading to bone stock preservation and no stress shielding or thigh pain.AIM To evaluate the early results after femoral revision in a consecutive series of patients undergoing surgery over 3 years.METHODS We included 116 patients in the study.They were operated in the period August 2011 to December 2014 and we got a clinical mean observation time of 4(0.5-6)years.Clinical and radiographical follow-up included present function of the hip assessed by Harris Hip Score,Oxford Hip Score,and EQ5D(measure of health outcome).Of the 116 patients,17 died in the interim and were consequently included only in the implant survivorship analysis;46 patients attended the follow-up control.RESULTS In total 6(5%)hips were re-revised due to infection(n=3),fracture(n=2)or subsidence(n=1).No patient was re-revised due to aseptic loosening.The 1-,2-and 5-year probability of implant survival(95%CI)were 97%(93%-100%),97%(93%-100%)and 96%(92%-99%),respectively.In this cohort 95 patients received a combination of a proximal broach and a distal curved and slotted stem(BS),aiming for proximal fixation and load bearing;21 patients received a different combination.When comparing these two groups the BS-group had a 5-year implant survival probability(95%CI)of 97%(93%-100%)compared with the group of other combinations with a 5-year implant survival probability(95%CI)of 90%(78%-100%)(P=0.3).Our regression analysis showed that periprosthetic fracture as an indication for the ARCOS operation was the only significant negative ouBACKGROUND The uncemented ArcosTM Modular Femoral Revision System（ARCOS） is a new comprehensive,press-fit revision design.The modular design offers a wide range of possible combinations to accommodate different variations of anatomy and bone stock.The ARCOS is made by a proximal body and a distal stem.As probably the only ones worldwide we predominantly use a combination of body and stem which supports proximal fixation and load,since this mimics the concept of the primary total hip arthroplasty with proximal weight-bearing,leading to bone stock preservation and no stress shielding or thigh pain.AIM To evaluate the early results after femoral revision in a consecutive series of patients undergoing surgery over 3 years.METHODS We included 116 patients in the study.They were operated in the period August2011 to December 2014 and we got a clinical mean observation time of 4（0.5-6）years.Clinical and radiographical follow-up included present function of the hip assessed by Harris Hip Score,Oxford Hip Score,and EQ5 D（measure of health outcome）.Of the 116 patients,17 died in the interim and were consequently included only in the implant survivorship analysis;46 patients attended the follow-up control.RESULTS In total 6（5%） hips were re-revised due to infection（n = 3）,fracture（n = 2） or subsidence（n = 1）.No patient was re-revised due to aseptic loosening.The 1-,2-and 5-year probability of implant survival（95%CI） were 97%（93%-100%）,97%（93%-100%） and 96%（92%-99%）,respectively.In this cohort 95 patients received a combination of a proximal broach and a distal curved and slotted stem（BS）,aiming for proximal fixation and load bearing;21 patients received a different combination.When comparing these two groups the BS-group had a 5-year implant survival probability（95%CI） of 97%（93%-100%） compared with the group of other combinations with a 5-year implant survival probability（95%CI）of 90%（78%-100%）（P = 0.3）.Our regression analysis showed that periprosthetic fra

关 键 词：Hip prosthesis ARTHROPLASTY IMPLANTATION Replacement arthroplasty Total hip replacements Modular femoral stem 

分 类 号：R687.3[医药卫生—骨科学]