Clinical outcomes of femoral revision using restoration modular stem
Notice bibliographique
Résumé
Objective To investigate the early outcomes of revision hip arthroplasty using restoration modular (RM) stem. Methods Fifty-nine patients underwent revision hip arthroplasty with RM stem from April 2012 to June 2015 in our center with a minimal of two years follow-up. The patients including 24 male and 35 female had a median age of 61.0 (56, 66) years. The median BMI was 24.0 (22.5, 26.0) kg/m2, while the median interval from the primary surgery was 10.5 (6.0, 14.5) years. The reasons for revision inculded infection in 8 patients, aseptic loosening in 45, recurrent dislocation in 1, and periprosthetic fracture in 5. There were 3 cases of type B2 and 2 cases of B3 periprosthetic fracture according to Vancouver classification. The bone defects severity was conducted according to Paprosky classification that 14 patients in type II, 31 in type IIIA, 8 in type IIIB, and 1 in type IV. Acetabular component were revised in 56 cases. Patients were followed up at 3 months, 6 months, 1 year and annually thereafter for clinical and radiological evaluation. Results All the patients were followed up with a median duration of 30.4 (27.3, 37.9) months, the median Harris score significantly improved from 37 (31, 53) points preoperatively to 84 (80, 95) points at the last follow up (Z=-6.681, P=0.000). There were 3 patients had perforation or fracture intra-operatively, two of them were fixed by strut allograft. The other one who did not compromise the implant stability was not fixed. Extended trochanteric osteotomy was applied in 14 cases and they healed well at 3-6 months during follow-up. There was one case of early dislocation at 6 days postoperatively, which was treated with close reduction and immobilization without recurrence. No infection, stem fracture, hematoma formation and sciatic nerve injury were reported. No femoral component loosening was identified at the latest follow-up. Median subsidence was 1.0 (0, 2.0) mm with the maximum case 6.0 mm and 3 cases 3.5 mm. All of subsidence developed within the first year postoperatively but without further aggravation. The affected leg lengthened 17.5±10.1 mm (range 2-40 mm) after operation. The affected leg was shorter 17.5±12.6 mm (shorter 44.4 mm to longer 3.0 mm) than that in the normal side pre-operatively. However, the distinction decreased to 0.1±9.6 mm postoperatively (shorter 24.8 mm to longer 22.4 mm, t=-10.538, P=0.000). Conclusion Early satisfactory results are achieved in hip revision using RM modular stem at the femoral side. The modular design could simplify the surgical procedure with better control of leg length and joint stability. Long-term follow-up is still required for further evaluation. Key words: Arthroplasty, replacement, hip; Femur; Reoperation; Prosthesis design; Osteolysis; Periprosthetic fractures; Prosthesis failure
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».