Abstract：
BACKGROUND: The increasing prevalence of primary hip arthroplasty has led to a parallel rise in revision cases. Femoral revision often entails compromised bone integrity, requiring consideration of various solutions for optimal reconstructive options. Despite technological advancements, there is limited evidence on the clinical outcomes of the latest modular revision stems. This study aimed to evaluate the clinical outcomes and survival rates of next generation uncemented modular revision stem in patients undergoing hip revision surgery.
METHODS: This retrospective single-center study assessed the survival and failure causes of a specific uncemented modular stem in 48 patients undergoing hip revision surgery between 2012 and 2022. Data included preoperative parameters, surgical details, and postoperative outcomes measured through clinical and radiographic assessments. Forty-eight patients (25 males, 23 females; mean age 72 years) were included, with a mean Charlson Comorbidity Index of 5. Preoperative diagnoses varied, with periprosthetic joint infection (PJI) being the most common (45.8%), followed by periprosthetic fractures (27.1%). Partial revisions occurred in 60.4%, total revisions in 39.6%. According to Paprosky classification of femoral bone loss, type II and III were the most represented, respectively 35.4% and 50%.
RESULTS: At a mean follow-up of 4.6 years, stem survival was 92.5%. Complications (20%) included dislocation, PJI, fracture, and loosening; the overall reoperation rate was 12.5%. The SF-12 physical score was 43.6, while the mental score was 51.1. The HOOS score was 71.8, and the HHS score was 71.4. Radiographic analysis identified nonprogressive osteolysis in 15.1% of patients.
CONCLUSIONS: This study on this uncemented modular revision stem demonstrated favorable outcomes in an elder fragile population with moderate to severe femoral bone loss. The implant\'s modularity provides versatility in addressing various defects, without any implant breakage observed during the study period. Literature comparison highlighted similar outcomes despite sample size differences. The promising results warrant continued investigation into the long-term survivorship of this modular stem system.
METHODS: This retrospective single-center study assessed the survival and failure causes of a specific uncemented modular stem in 48 patients undergoing hip revision surgery between 2012 and 2022. Data included preoperative parameters, surgical details, and postoperative outcomes measured through clinical and radiographic assessments. Forty-eight patients (25 males, 23 females; mean age 72 years) were included, with a mean Charlson Comorbidity Index of 5. Preoperative diagnoses varied, with periprosthetic joint infection (PJI) being the most common (45.8%), followed by periprosthetic fractures (27.1%). Partial revisions occurred in 60.4%, total revisions in 39.6%. According to Paprosky classification of femoral bone loss, type II and III were the most represented, respectively 35.4% and 50%.
RESULTS: At a mean follow-up of 4.6 years, stem survival was 92.5%. Complications (20%) included dislocation, PJI, fracture, and loosening; the overall reoperation rate was 12.5%. The SF-12 physical score was 43.6, while the mental score was 51.1. The HOOS score was 71.8, and the HHS score was 71.4. Radiographic analysis identified nonprogressive osteolysis in 15.1% of patients.
CONCLUSIONS: This study on this uncemented modular revision stem demonstrated favorable outcomes in an elder fragile population with moderate to severe femoral bone loss. The implant\'s modularity provides versatility in addressing various defects, without any implant breakage observed during the study period. Literature comparison highlighted similar outcomes despite sample size differences. The promising results warrant continued investigation into the long-term survivorship of this modular stem system.
摘要：
背景：初次髋关节置换术的患病率增加导致翻修病例的平行增加。股骨翻修术通常会导致骨完整性受损，需要考虑各种解决方案，以获得最佳的重建方案。尽管技术进步,关于最新模块化修订茎的临床结局的证据有限.这项研究旨在评估接受髋关节翻修手术的患者的下一代未加固模块化翻修茎的临床结果和生存率。
方法：这项回顾性单中心研究评估了2012年至2022年间接受髋关节翻修手术的48例患者中特定非骨水泥模块茎的生存和失败原因。数据包括术前参数，手术细节,以及通过临床和影像学评估测量的术后结局。48名患者（25名男性，包括23名女性；平均年龄72岁），平均Charlson合并症指数为5。术前诊断各不相同，假体周围感染（PJI）是最常见的（45.8％），其次是假体周围骨折（27.1%）。部分修订发生在60.4%，总修订为39.6%。根据Poprosky分类的股骨骨丢失,II型和III型是最多的，分别为35.4%和50%。
结果：平均随访4.6年，茎存活率为92.5%。并发症（20%）包括脱位，PJI,骨折,和松动；总体再手术率为12.5%。SF-12的身体评分为43.6，而心理评分为51.1。HOOS评分为71.8，HHS评分为71.4。影像学分析发现15.1%的患者存在非进行性骨溶解。
结论：这项关于这种未加固的模块化翻修茎的研究在患有中度至重度股骨骨丢失的老年脆弱人群中显示出良好的结局。植入物的模块化提供了解决各种缺陷的多功能性，在研究期间没有观察到任何植入物破损。尽管样本量存在差异，但文献比较突出了相似的结果。有希望的结果值得继续研究该模块化茎系统的长期生存能力。
方法：这项回顾性单中心研究评估了2012年至2022年间接受髋关节翻修手术的48例患者中特定非骨水泥模块茎的生存和失败原因。数据包括术前参数，手术细节,以及通过临床和影像学评估测量的术后结局。48名患者（25名男性，包括23名女性；平均年龄72岁），平均Charlson合并症指数为5。术前诊断各不相同，假体周围感染（PJI）是最常见的（45.8％），其次是假体周围骨折（27.1%）。部分修订发生在60.4%，总修订为39.6%。根据Poprosky分类的股骨骨丢失,II型和III型是最多的，分别为35.4%和50%。
结果：平均随访4.6年，茎存活率为92.5%。并发症（20%）包括脱位，PJI,骨折,和松动；总体再手术率为12.5%。SF-12的身体评分为43.6，而心理评分为51.1。HOOS评分为71.8，HHS评分为71.4。影像学分析发现15.1%的患者存在非进行性骨溶解。
结论：这项关于这种未加固的模块化翻修茎的研究在患有中度至重度股骨骨丢失的老年脆弱人群中显示出良好的结局。植入物的模块化提供了解决各种缺陷的多功能性，在研究期间没有观察到任何植入物破损。尽管样本量存在差异，但文献比较突出了相似的结果。有希望的结果值得继续研究该模块化茎系统的长期生存能力。
