PROXIMAL IMPACTION ALLOGRAFTING FOR FEMORAL REVISION USING THE OXFORD TRIMODULAR STEM

Isaac SM, Hauptfleisch J, Fawzy E, et al. PROXIMAL IMPACTION ALLOGRAFTING FOR FEMORAL REVISION USING THE OXFORD TRIMODULAR STEM. Orthop Procs. 2005;87-B(SUPP_I):50-50. doi:10.1302/0301-620X.87BSUPP_I.0870050a

Isaac, S M, et al. “PROXIMAL IMPACTION ALLOGRAFTING FOR FEMORAL REVISION USING THE OXFORD TRIMODULAR STEM.” Orthopaedic Proceedings, vol. 87-B, no. SUPP_I, 2005, pp. 50-50., https://doi.org/10.1302/0301-620X.87BSUPP_I.0870050a

Isaac, S. M., Hauptfleisch, J., Fawzy, E., Kellett, C., Pandit, H., Gundle, R., Murray, D., & McLardy-Smith, P. (2005). PROXIMAL IMPACTION ALLOGRAFTING FOR FEMORAL REVISION USING THE OXFORD TRIMODULAR STEM. Orthopaedic Proceedings, 87-B(SUPP_I), 50-50. https://doi.org/10.1302/0301-620X.87BSUPP_I.0870050a

Isaac, S. M., Hauptfleisch, J., Fawzy, E., Kellett, C., Pandit, H., Gundle, R. et al. (2005) “PROXIMAL IMPACTION ALLOGRAFTING FOR FEMORAL REVISION USING THE OXFORD TRIMODULAR STEM.” Orthopaedic Proceedings, 87-B(SUPP_I), pp. 50-50. Available at: https://doi.org/10.1302/0301-620X.87BSUPP_I.0870050a

Isaac, S M, J Hauptfleisch, E Fawzy, C Kellett, H Pandit, R Gundle, D Murray, and P McLardy-Smith. “PROXIMAL IMPACTION ALLOGRAFTING FOR FEMORAL REVISION USING THE OXFORD TRIMODULAR STEM.” Orthopaedic Proceedings 87-B, no. SUPP_I (2005): 50-50. https://doi.org/10.1302/0301-620X.87BSUPP_I.0870050a

Isaac SM, Hauptfleisch J, Fawzy E, Kellett C, Pandit H, Gundle R, et al. PROXIMAL IMPACTION ALLOGRAFTING FOR FEMORAL REVISION USING THE OXFORD TRIMODULAR STEM. Orthop Procs. 2005 Mar 1;87-B(SUPP_I):50-50. https://doi.org/10.1302/0301-620X.87BSUPP_I.0870050a

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Abstract

Purpose of the study: To evaluate the clinical outcome of revision total hip arthroplasty (THA) using the Oxford Hip prosthesis combined with impaction allografting. Methods and results: The Oxford hip is a trimodular prosthesis with a polished tapered metaphyseal section that is free to slide on the stem. The stem is inserted uncemented into the diaphysis, bone graft is impacted proximally, with mesh if necessary, and then the proximal wedge is cemented in.

Between 1999 and 2002, we revised 72 hips in 69 patients using this technique (mean age 65years, 28 to 88). Fifty-six cases had aseptic loosening, 8 had infection (2 stages), 7 had peri-prosthetic fractures and 1 had a broken stem. The mean time to revision was 8.5years (1 to 21). Patients were assessed clinically and with the Oxford Hip Score (OHS) pre- and post-operatively. Fifty-seven patients also had acetabular revision. Four patients required femoral osteotomy to remove the old prosthesis. We used a mean of 1.8 (1 to 4) femoral heads per operation.

Complications included 6 peri-operative femoral fractures diagnosed at operation and fixed successfully, 6 infections, 10 dislocations (2 were recurrent), one deep vein thrombosis, 2 pulmonary embolism and one gastrointestinal haemorrhage. The average blood transfusion was 1.8 units (0 to 9).

The OHS improved from 45 (26 to 58) pre-operatively to 24.3 post-operatively (12 to 43). No hip has been re-revised for aseptic loosening at a mean follow-up of 32.7 months (16 to 51).

Conclusion: Although we accept that this is only a preliminary experience, we believe that the use of the trimodular Oxford stem combined with minimal proximal impaction allografting was found to be a reliable method and a successful way of dealing with revision femoral surgery. The results were comparable with a primary arthroplasty in terms of pain relief and functional results

The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.