DOS BULLETIN - Dansk Ortopædisk Selskab

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