Department of Trauma and Orthopaedic Surgery, University of Alexandria, Alexandria, Egypt.
Department of Orthopaedic Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Int Orthop. 2022 Mar;46(3):531-539. doi: 10.1007/s00264-021-05237-5. Epub 2021 Oct 12.
Modular design in revision hip surgery allows some flexibility intra-operatively to address leg length discrepancy, version, and offset while allowing the surgeon to bypass a deficient proximal femur and achieve axial and rotational stability distally. The purpose of this study was to analyze the mid-term to long-term survival and clinical and radiological outcomes using a conical fluted stem and a cone-shaped hydroxyapatite-coated proximal body "The Cone-Conical modular system (Stryker)" in revision hip surgery.
We retrospectively reviewed all the patients who underwent hip revision surgery using Cone-Conical modular system between January 2006 and January 2015 at our institution. Seventy patients (72 hips) were included with a mean age of 71.3 years. We had a mean follow-up period of 8.6 years (range 5-15). All patients had a minimum follow-up of five years. A Kaplan-Meier analysis was used to determine the survival of the implant. Functional outcomes were assessed using Oxford Hip Score. Plain radiographs were performed to assess implant fixation and osseointegration.
The mean OHS improved significantly from 12 pre-operatively to 34 at the final follow-up (P < .001). The Cone-Conical system survivorship for aseptic loosening as an end point was 100%. The all-cause survivorship was 97.2%. Two hips had revisions for recurrence of infection.
The Cone-Conical femoral modular revision system has demonstrated excellent mid-term to long-term clinical and radiographic results with low failure rate and minimal complications. Longer-term follow-up would be of value to assess the ongoing survival of this implant.
在髋关节翻修术中，模块化设计允许在术中具有一定的灵活性，以解决下肢长度差异、角度和偏移问题，同时允许外科医生绕过缺陷的股骨近端并在远端实现轴向和旋转稳定性。本研究旨在分析使用锥形开槽柄和锥形羟基磷灰石涂层近端体（“锥形-锥形模块化系统（Stryker）”）进行髋关节翻修手术的中期至长期生存率以及临床和影像学结果。
我们回顾性分析了 2006 年 1 月至 2015 年 1 月在我院接受 Cone-Conical 模块化系统髋关节翻修手术的所有患者。共纳入 70 例患者（72 髋），平均年龄为 71.3 岁。平均随访时间为 8.6 年（5-15 年）。所有患者的随访时间均至少为 5 年。采用 Kaplan-Meier 分析确定植入物的生存率。采用牛津髋关节评分（Oxford Hip Score）评估功能结果。拍摄平片评估植入物固定和骨整合情况。
平均 OHS 从术前的 12 分显著改善至末次随访时的 34 分（P < .001）。作为终点的无菌性松动的 Cone-Conical 系统生存率为 100%。总生存率为 97.2%。有 2 髋因感染复发而进行了翻修。
锥形股骨模块化翻修系统具有出色的中期至长期临床和影像学结果，失败率低，并发症少。更长时间的随访将有助于评估该植入物的持续生存率。
