Department of Orthopaedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, P. R. China.
Arch Orthop Trauma Surg. 2013 Feb;133(2):275-81. doi: 10.1007/s00402-012-1644-y. Epub 2012 Nov 3.
Modular femoral prostheses can provide independent distal fixation and intraoperative flexibility and are being used increasingly, especially in patients with proximal femoral bone defects. This retrospective clinical study evaluated whether modular prostheses were effective and reliable implants for femoral revision.
This case series consisted of 58 patients who underwent hip revision with a tapered modular femoral prosthesis at our institution between 2004 and 2008. Mean patient age at surgery was 64 years (range 18-86 years). Femoral bone defects before revision surgery were evaluated using the Paprosky classification. All patients were followed for a minimum of 3 years (mean 4.3 years, range 3-7 years) with clinical and radiographic evaluation. Re-revisions and complications were also recorded.
Two stems required re-revision, one each for recurrent deep infection and periprosthetic fracture. At last follow-up, the Harris Hip Score and Visual Analog Pain Scores had improved significantly, the median radiographic stem migration was 1.6 mm, leg length discrepancy was corrected in 64 % of the patients and osseointegration occurred in 90 %. Complications included intraoperative fracture in 10 (17 %) patients and hip dislocation in 2 (3 %).
Modular femoral components can improve hip function, provide distal fixation, equalize leg length, and result in fewer complications when used to revise failed femoral components.
模块化股骨假体可提供独立的远端固定和术中灵活性，因此越来越多地被使用，尤其是在股骨近端骨缺损的患者中。本回顾性临床研究评估了模块化假体作为股骨翻修的有效且可靠的植入物的效果。
本病例系列纳入 2004 年至 2008 年期间在我院接受锥形模块化股骨假体髋关节翻修的 58 例患者。手术时患者的平均年龄为 64 岁（18-86 岁）。在翻修术前使用 Paprosky 分类评估股骨骨缺损。所有患者均接受了至少 3 年（平均 4.3 年，3-7 年）的临床和影像学随访。记录再次翻修和并发症的情况。
有 2 例假体需要再次翻修，分别因深部感染复发和假体周围骨折而翻修。末次随访时，Harris 髋关节评分和视觉模拟疼痛评分显著改善，中位数影像学假体迁移为 1.6mm，64%的患者下肢长度差异得到纠正，90%的患者发生骨整合。并发症包括 10 例（17%）患者术中骨折和 2 例（3%）髋关节脱位。
在翻修失败的股骨假体时，使用模块化股骨组件可改善髋关节功能，提供远端固定，使下肢长度均等，并减少并发症。
