Cementless revision femoral stems application of press-fit principles and clinical outcomes.

Background: Cementless femoral stems are currently used in revision total hip arthroplasty (THA) with the surgeon choosing between various fixation modes. The outcomes are good in the medium term; however, some failures have been attributed to technical errors during implantation. When the decision has been made to use a press-fit implant, the impact of the surgeon's technique on the functional outcomes have not been explored in-depth.

Global radiological score for femoral cementless revision stem.

Purpose: The purpose of this study was to evaluate the outcomes of total hip arthroplasty (THA) revision with cementless stems using a numeric global radiological score (GRxS) that summarizes two previously validated scores: secondary bone stock (SBS) and osseointegration-secondary stability (O-SS).

Method: One hundred fifty cases of THA were evaluated at a mean follow-up of 6.5 ± 3.

Assessment of fixation in cementless femoral revision of total hip arthroplasty: comparison of the Engh score versus radiolucent line measurement.

Purpose: To assess osseointegration and stability of a primary cementless femoral stem, many scoring systems have been developed, but none of them have taken into account only the radiolucent line. The purposes of this study were (1) to compare the results between the Engh score to assess osseointegration and stability of the cementless stem with results of a score called the O-SS score (osseointegration-secondary stability), which takes into account the radiolucent line, (2) to verify the relationship between these two scores and the functional results, and (3) to verify if there is a relationship between the O-SS score and secondary subsidence or a pedestal.

Methods: A clinical and radiological evaluation was performed in a group of 100 hip prosthesis revisions comparing the results obtained by Engh score and O-SS score for which reproducibility was analysed.

Bone density and functional results after femoral revision with a cementless press-fit stem.

Introduction: The influence of radiographic bone density changes in the area surrounding a total hip arthroplasty (THA) revision with a cementless press-fit stem is unknown, notably in terms of functional results. We have therefore conducted a study aiming to (1) propose a radiographic method to assess bone density, (2) measure the functional effects of reduced bone density, and (3) determine the factors contributing to these modifications.

Hypothesis: A reduction in radiographic bone density has a negative influence on the functional result after revision using a cementless press-fit stem.

Bone stock in revision femoral arthroplasty: a new evaluation.

Purpose: The purpose of this study was to finalize a method allowing a qualitative and numerical evaluation of the bone stock and to confirm its reproducibility, to verify the relationship between the secondary bone stock value and the functional results, and to determine the main factors influencing the value of the bone stock.

Methods: A clinical and radiological evaluation was performed in a group of 150 revisions of total hip replacements according to a new method taking into account cortical bone thickness, bone density and bone defects.

Results: Interobserver reproducibility was evaluated at an average of 0.

Stem and osteotomy length are critical for success of the transfemoral approach and cementless stem revision.

Background: The transfemoral approach is an extensile surgical approach that is performed routinely to facilitate cement and implant removal and improve exposure for revision stem implantation. Previous studies have looked at clinical results of small patient groups. The factors associated with fixation failure of cementless revision stems when using this approach have not been examined.

Stem subsidence after total hip revision: 183 cases at 5.9 years follow-up.

Introduction: Secondary subsidence of a revision femoral stem is often a negative predictive sign for successful osseointegration and perfect long-term stability.

Materials And Methods: We performed a retrospective study in a series of 183 revision total hip replacements between 1996 and 2000 to evaluate the importance and risk factors of secondary subsidence with a cementless press-fit design femoral stem as well as this subsidence's consequences to osseointegration.

Results: Secondary subsidence did not occur in 80 cases (53%), was between 0 and 4mm in 41 cases (27%); between 5 and 10mm in 17 cases (12%) and was greater than 10mm in 12 cases (8%).

[Mucoid pseudo-cysts of the sheath of the external popliteal sciatic nerve. Apropos of 2 cases].

Two cases of paralysis of the etxernal popliteal sciatic nerve are described. They are secondary to the development of a pseudo-cyst containing mucoid matter within the connective tissue sheath of the nerve itself. The authors describe the pathological anatomy of these lesions and discuss their aetiology, favouring the theory of mucoid degeneration of the connective tissues of the nerve sheath.