DOS BULLETIN - Dansk Ortopædisk Selskab
DOS BULLETIN - Dansk Ortopædisk Selskab
DOS BULLETIN - Dansk Ortopædisk Selskab
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2010-378_<strong>DOS</strong> nr. 3 2010 29/09/10 10:08 Side 79<br />
Excellent long term survival and performance of the<br />
non-modular extensively porouscoated SOLUTION<br />
stem in hip revision arthroplasty<br />
Per B Thomsen, Niels Jensen, Jens Kampmann<br />
Orthopaedic Clinic and Orthopaedic Research Unit,<br />
Regional Hospital Holstebro and Hospital Unit West<br />
Background: Results after hip revision surgery have for many decades<br />
been bad or at least questionable in spite of various surgical concepts.<br />
Purpose: We report up to 18 years performance of an extensively<br />
porouscoated chrome- cobalt stem designed for diaphyseal fixation.<br />
Methods: Over a 15 years period 200 uncemented SOLUTION stem<br />
revisions were performed and form the basis of survival calculations. At<br />
follow-up in 2010 the first consecutive 93 hips were 10 years or more<br />
after surgery and form the basis of clinical and radiographical examination<br />
done by an independent observer (NJ)<br />
Findings: Life tables show 18 years stem survival free of revision for<br />
any reason of 96%, for infection of 98.2%, for aseptic loosening of<br />
98.9% and for stem fracture of 99.1% respectively. Of the 93 hips with<br />
10 or more years follow-up 48 were dead. 4 were revised and 5 hips did<br />
not attend. This leaves 36 hips/29 pts. for examination 14.3 years (10.0-<br />
17.3) after index stem revision. Harris Hip Score was 85 (53-99) and<br />
Pain Score 42.8 (30-44). These results have not deteriorated since 5 and<br />
10 years follow-up examination. Radiographs showed osseointegration<br />
of 34 stems and fibrous fixation of two. Progressive but proximal osteolysis<br />
was seen in one hip, stem subsidence in 3 and significant stressshielding<br />
in 9 hips.<br />
Conclusion: The concept of diaphyseal fixation in femoral stem revision<br />
has in this study stood the test of time.<br />
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