Notas / Notes - Active Congress.......

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27. Ornstein. E, Atroshi. I, Franzen. H, Johnsson. R, Sandquist.
P and Sundberg. M: Early complications after one
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and Joint Surg., 84-A: 1323-1328.2002.
28. Raut. VV, Siney. PD, Wroblewski. BM: Outcome of revision
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29. Souminen. S, and Santavirta. S: Revision total hip arthroplasty
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31. Wagner. H: A non allogaft press fit alternative. Current
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32. Young-Min Kim, Hee Joong Kim, Won Seok Song, Jeong
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LONG TERM RESULTS IN HA-COATED
REVISION HIP ARTHROPLASTY
Rudolph Geesink MD PhD
Professor of Orthopaedic Surgery, Maastricht University,
Netherlands
The goal of hip revision surgery is to restore longevity of
pain-free function that has been disturbed by one of the
many failure mechanisms in arthroplasty.
Main challenges include:
- provide stable fixation of the new implant
- provide stable joint resistant against dislocation
- restore the bone that has been damaged by osteolysis and
stress-shielding
Progress in fixation biology through the use of HA-coatings
has permitted expanded indications for the use of HA-coated
implants in revision arthroplasty, especially on the femoral
side. HA-coatings have been used in revision arthroplasty
since 1986 in several stages of evolution. The first generation
of implants using HA-coated Omnifit stems with now 20 years
follow-up has resulted in excellent long term survival although
the scope of application was somewhat limited as it is actually
a primary stem. Long term follow-up of 63 cases initially with
average age of 53 years at time of revision surgery and 61%
multi-revisions showed survival rates at minimum 15 year
follow-up of 92%.
Based upon the same design characteristics the evolutionary
HA-coated Restoration stem became available in 1997 with
variable stem lengths and diameters followed by the even
more flexible modular successor in 2005. They have greatly
expanded the versatility and success rate even in complex
revision surgery. Although the numbers have increased,
follow-up is still limited but based on the excellent results of
previous generations where upon its design was based we
can expect excellent and reliable long term results. Initial
complication rate is low and the early mechanical failure rate
is below 2%.
FRACTURAS PERIPROTÉSICAS
DE FÉMUR
Carles Mestre
Hospital de l’Esperança. IMAS. Barcelona (Spain)
TWO- TO FIVE-YEAR FOLLOW-UP OF
MOSTLY TYPE III FEMORAL DEFECTS IN
REVISION THR TREATED WITH THE LINK
MP STEM
Rodriguez JA, Fada R, Murphy SB, Rasquinha VJ,
Ranawat CS
Lenox Hill Hospital. New York (USA)
BACKGROUND
Femoral bone deficiency has been shown to adversely affect
the results of revision THR. Tapered titanium modular stems
allow distal fixation of the fluted, conical portion of the stem
in the remaining bone, and may be a more versatile approach
to fixation in the setting of proximal bone loss.
METHODS
One hundred and two consecutive hips with proximal bone
loss underwent revision femoral reconstruction between 1998
and 2002 at 3 centers using the Link-MP modular stem. Fortythree
hips had Mallory Type 3C femoral deficiency. Ninety-