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Management of Severe Bone Defects in Femoral Revision following Total Hip Arthroplasty

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Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porouscoated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.

Abstract

Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porouscoated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.

참고문헌 (44)

  1. Kurtz S, "Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030", J Bone Joint Surg Am, 89, pp.780~785 (2007)[DOI]
  2. Patel A, "The epidemiology of revision total knee and hip arthroplasty in England and Wales : a comparative analysis with projections for the United States. A study using the National Joint Registry dataset", Bone Joint J, 97-B, pp.1076~1081 (2015)[DOI]
  3. Ong KL, "Economic burden of revision hip and knee arthroplasty in Medicare enrollees", Clin Orthop Relat Res, 446, pp.22~28 (2006)[DOI]
  4. Dixon T, "Trends in hip and knee joint replacement : socioeconomic inequalities and projections of need", Ann Rheum Dis, 63, pp.825~830 (2004)[DOI]
  5. Vanhegan IS, "A financial analysis of revision hip arthroplasty : the economic burden in relation to the national tariff", J Bone Joint Surg Br, 94, pp.619~623 (2012)[DOI]
  6. Paprosky WG, "Minimum 10-yearresults of extensively porous-coated stems in revision hip arthroplasty", Clin Orthop Relat Res, (369), pp.230~242 (1999)[DOI]
  7. Otero JE, "Radiographic and clinical outcomes of modular tapered fluted stems for femoral revision for Paprosky III and IV femoral defects or Vancouver B2 and B3 femoral fractures", J Arthroplasty, 35, pp.1069~1073 (2020)[DOI]
  8. Richards CJ, "Femoral revision hip arthroplasty : a comparison of two stem designs", Clin Orthop Relat Res, 468, pp.491~496 (2010)[DOI]
  9. Clohisy JC, "Reasons for revision hip surgery : a retrospective review", Clin Orthop Relat Res, (429), pp.188~192 (2004)[DOI]
  10. Dobzyniak M, "Early failure in total hip arthroplasty", Clin Orthop Relat Res, 447, pp.76~78 (2006)[DOI]
  11. Huang Y, "Femoral bone remodeling in revision total hip arthroplasty with use of modular compared with monoblock tapered fluted titanium stems : the role of stem length and stiffness", J Bone Joint Surg Am, 101, pp.531~538 (2019)[DOI]
  12. D'Antonio J, "Classification of femoral abnormalities in total hip arthroplasty", Clin Orthop Relat Res, (296), pp.133~139 (1993)
  13. Tetreault MW, "Are short fully coated stems adequate for"simple"femoral revisions?", Clin Orthop Relat Res, 472, pp.577~583 (2014)[DOI]
  14. Khanuja HS, "Results of a tapered proximally-coated primary cementless stem for revision hip surgery", J Arthroplasty, 29, pp.225~228 (2014)[DOI]
  15. Romagnoli S, "Conical primary cementless stem in revision hip arthroplasty : 94 consecutive implantations at a mean followup of 12. 7 years", J Arthroplasty, 36, pp.1080~1086 (2021)[DOI]
  16. McAuley JP, "Femoral fixation in the face of considerable bone loss : cylindrical and extensively coated femoral components", Clin Orthop Relat Res, (429), pp.215~221 (2004)[DOI]
  17. Davidson D, "Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management", J Bone Joint Surg Am, 90, pp.2000~2012 (2008)[DOI]
  18. Pinaroli A, "Conservative femoral stem revision : avoiding therapeutic escalation", J Arthroplasty, 24, pp.365~373 (2009)[DOI]
  19. Skibicki HE, "A role for modern primary cementless femoral stems in revision hip arthroplasty", J Arthroplasty, 36, pp.3269~3274 (2021)[DOI]
  20. Cavagnaro L, "Femoral revision with primary cementless stems : a systematic review of the literature", Musculoskelet Surg, 102, pp.1~9 (2018)[DOI]
  21. Sporer SM, "Revision total hip arthroplasty : the limits of fully coated stems", Clin Orthop Relat Res, (417), pp.203~209 (2003)[DOI]
  22. Chung LH, "Extensively porous-coated stems for femoral revision : reliable choice for stem revision in Paprosky femoral type III defects", Orthopedics, 35, pp.e1017~e1021 (2012)[DOI]
  23. Ding ZC, "Minimum 8-year followup of revision THA with severe femoral bone defects using extensively porous-coated stems and cortical strut allografts", BMC Musculoskelet Disord, 21, pp.218~ (2020)[DOI]
  24. Palumbo BT, "Results of revision total hip arthroplasty with modular, titanium-tapered femoral stems in severe proximal metaphyseal and diaphyseal bone loss", J Arthroplasty, 28, pp.690~694 (2013)[DOI]
  25. Desai RR, "Revision total hip arthroplasty using a modular femoral implant in Paprosky type III and IV femoral bone loss", J Arthroplasty, 27, pp.1492~1498 (2012)[DOI]
  26. Chang JD, "Revision total hip arthroplasty using a tapered, press-fit cementless revision stem in elderly patients", J Arthroplasty, 26, pp.1045~1049 (2011)[DOI]
  27. Uriarte I, "Revision hip arthroplasty with a rectangular tapered cementless stem : a retrospective study of the SLRPlus stem at a mean follow-up of 4. 1 years", Eur J Orthop Surg Traumatol, 30, pp.281~289 (2020)[DOI]
  28. Korovessis P, "High medium-term survival of Zweymüller SLR-plus stem used in femoral revision", Clin Orthop Relat Res, 467, pp.2032~2040 (2009)[DOI]
  29. Wang J, "Revision total hip arthroplasty in patients with femoral bone loss using tapered rectangular femoral stem : a minimum 10 years' follow-up", Hip Int, 30, pp.622~628 (2020)[DOI]
  30. Ling RS, "Femoral component revision using impacted morsellised cancellous graft", J Bone Joint Surg Br, 79, pp.874~875 (1997)[DOI]
  31. Rogers BA, "Proximal femoral allograft in revision hip surgery with severe femoral bone loss : a systematic review and meta-analysis", J Arthroplasty, 27, pp.829~836 (2012)[DOI]
  32. Ling RS, "Histology of cancellous impaction grafting in the femur. A case report", J Bone Joint Surg Br, 75, pp.693~696 (1993)[DOI]
  33. Board TN, "Strain imparted during impaction grafting may contribute to bony incorporation : an in vitro study of the release of BMP-7 from allograft", J Bone Joint Surg Br, 90, pp.821~824 (2008)[DOI]
  34. Hadley ML, "Intussusception allograft prosthetic composites in total hip arthroplasty : a salvage operation for extensive femoral bone loss", J Arthroplasty, 38, pp.1827~1838 (2023)[DOI]
  35. Viste A, "Proximal femoral replacement in contemporary revision total hip arthroplasty for severe femoral bone loss : a review of outcomes", Bone Joint J, 99-B, pp.325~329 (2017)[DOI]
  36. Yacovelli S, "Modern revision femoral stem designs have no difference in rates of subsidence", J Arthroplasty, 36, pp.268~273 (2021)[DOI]
  37. Russell RD, "Tapered vs cylindrical stem fixation in a model of femoral bone deficiency in revision total hip arthroplasty", J Arthroplasty, 31, pp.1352~1355 (2016)[DOI]
  38. Zhang Y, "Comparison of cylindrical and tapered stem designs for femoral revision hip arthroplasty", BMC Musculoskelet Disord, 21, pp.411~ (2020)[DOI]
  39. Weeden SH, "Minimal 11-year follow-up of extensively porous-coated stems in femoral revision total hip arthroplasty", J Arthroplasty, 17(4 Suppl 1), pp.134~137 (2002)[DOI]
  40. Sivananthan S, "Revision hip arthroplasty using a modular, cementless femoral stem : intermediate-term followup", J Arthroplasty, 32, pp.1245~1249 (2017)[DOI]
  41. Pelt CE, "Revision total hip arthroplasty with a modular cementless femoral stem", J Arthroplasty, 29, pp.1803~1807 (2014)[DOI]
  42. Regis D, "Femoral revision with the Wagner tapered stem : a ten-to 15-year follow-up study", J Bone Joint Surg Br, 93, pp.1320~1326 (2011)[DOI]
  43. Abdel MP, "Modular fluted tapered stems in aseptic revision total hip arthroplasty", J Bone Joint Surg Am, 99, pp.873~881 (2017)[DOI]
  44. Huang Y, "What is the difference between modular and nonmodular tapered fluted titanium stems in revision total hip arthroplasty", J Arthroplasty, 32, pp.3108~3113 (2017)[DOI]

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