Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 24097
STEM REVISION OF THE HIP USING AN UNCEMENTED MODULUS SYSTEM
AND ACCORD PLATE
Fujio HIGUCHI, Yumiko ISHIBASHI, Tokiko SIMOYAMA, Takahiro OKAWA,
Shinichiro KUME, Masafumi GOTOH, Yoshida SHIRO, Kyoko ARAKI
Kurume University Medical Center Department Orthopaedic Surgery and Center for
Joint Surgery, Kurume (JAPAN)
Since 2006, we have used an uncemented modulus system (Lima Co.) with Accord
plate (Smith & Nephew Co.) for stem revision in 14 hips. These cases involved
loosening in the femoral component in 8, recurrent dislocation in 2, periprosthetic
fracture in 2, and infection with pain of unknown cause in the other 1. Methods: The
surgical approach was transtrochanteric according to Charnley in 2, Charnley and
fenestration of the femoral shaft in 2, transfemoral according to Wagner in 9, and
extended transtrochanteric according to Gundolf in the other 1. Preoperative
radiographical findings were classified according to Paprosky (2003), as type II in 2,
type IIIA in 11, and cement spacer in 1. The postoperative management was bed rest
for 2 days, sitting and moving in a wheelchair from day 4, partial weight bearing gait
from week 4, and full weight bearing gait from week 8.Results: Painless walk was
achieved in all cases. There were some complications; stem subsidence in 2, hip
dislocation in 1, but no infection and no deep vein thrombosis. No revision was
needed. Conclusions: 1. The modulus revision stem was too large in the metaphysis
of the femur for some revision cases of small Japanese old women. 2. Combination
with the Accord plate was performed via the transfemoral approach which was easy
for removing the femoral component. 3. Combination with the Accord plate permitted
earlier recovery even after invasive revision.
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