Fully hydroxyapatite-coated distal locking cementless femoral modular implant for revision total hip arthroplasty: A retrospective study of 94 Renaissance™ stems at a minimum 10 years' follow-up.

Abstract

INTRODUCTION:

Modular locking revision total hip arthroplasty femoral implants have been little assessed over the long term. We therefore conducted a retrospective assessment of the Renaissance™ fully hydroxyapatite-coated distal locking cementless femoral modular revision implant at a minimum 10 years' follow-up, analyzing: 1) survivorship, 2) complications, 3) radiologic and functional results, and 4) prevalence of thigh pain.

HYPOTHESIS:

This implant shows more than 90% 10-year survival.

MATERIAL AND METHOD:

Between December 2002 and December 2008, 213 implant exchanges were performed in 206 patients, including 97 Renaissance™ stems in 93 patients. Three patients were excluded for missing data. Survival was analyzed for 94 stems in 90 patients at a mean 11.2±3 years' follow-up; radiographic and clinical assessment was performed for 48 stems in 45 patients. The survival criterion was implant fracture and/or femoral stem removal.

RESULTS:

Survival was 93.5% at 10 years (95% CI: 86-97) and 91.3% at 15 years (95% CI: 82.9-96). Eight stems (8.5%) were exchanged or removed by last follow-up: 5 for infection (5.3%) and 3 for implant breakage (3.2%). The complications rate was 18.1% (N=17, including the 8 stem revisions): 3 stem exchanges for breakage (3.2%), 9 stem infections (9.6%), 3 dislocations (3.2%), and 2 traumatic greater trochanter fractures (2.1%). For the 45 patients with long-term clinical assessment, the mean Postel Merle d'Aubigné and Harris Hip scores were respectively 15±3 and 80 ±19 at last follow-up. Metaphysis reconstruction was satisfactory in 36/48 cases (75.0%). Seven of the 48 stems (14.6%) assessed at longest follow-up, in 45 patients, were causing thigh pain, unrelated to stress-shielding, distal locking screws or metaphyseal filling index.

DISCUSSION:

The Renaissance™ fully hydroxyapatite-coated modular locking stem with curved nail showed 90% 10-year survival, with satisfactory functional results and little thigh pain.

LEVEL OF EVIDENCE:

IV; case study without control group.

• Authors: Fabien Slomka, Jérôme Druon, Philippe Rosset, Louis-Romée Le Nail
• Journal: Orthopaedics & traumatology, surgery & research : OTSR (Orthop Traumatol Surg Res) Vol. 108 Issue 6 Pg. 103233 (10 2022) ISSN: 1877-0568 [Electronic] France
• PMID: 35124250 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier Masson SAS. All rights reserved.

Chemical References

• Durapatite

Topics

• Arthroplasty, Replacement, Hip (methods)
• Durapatite
• Femur (surgery)
• Follow-Up Studies
• Hip Prosthesis
• Humans
• Pain (surgery)
• Prosthesis Design
• Prosthesis Failure
• Reoperation
• Retrospective Studies
• Treatment Outcome