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Total hip arthroplasty using a short-stemmed femoral component in the presence of a long dynamic condylar screw osteosynthesis plate.

Buttaro M, Piuzzi N, Comba F, Zanotti G, Piccaluga F - Case Rep Orthop (2014)

Bottom Line: We present a potential indication of a short-stemmed femoral component in a patient with multiple comorbidities presenting with hip posttraumatic osteoarthritis and a long dynamic condylar screw osteosynthesis plate.Removal of the plate and implantation of a long stem would have been related to a much longer operative time and potential local or systemic complications.

View Article: PubMed Central - PubMed

Affiliation: The Hip Surgery Unit, Institute of Orthopaedics "Carlos E. Ottolenghi", Italian Hospital of Buenos Aires, Potosí 4247, C1199ACK Buenos Aires, Argentina.

ABSTRACT
We present a potential indication of a short-stemmed femoral component in a patient with multiple comorbidities presenting with hip posttraumatic osteoarthritis and a long dynamic condylar screw osteosynthesis plate. Removal of the plate and implantation of a long stem would have been related to a much longer operative time and potential local or systemic complications.

No MeSH data available.


Related in: MedlinePlus

Anteroposterior (a) and lateral (b) radiographs of the left hip one year after the conversion to a short-stemmed THA.
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fig2: Anteroposterior (a) and lateral (b) radiographs of the left hip one year after the conversion to a short-stemmed THA.

Mentions: Removal of this screw was performed in an anterograde way as it is not possible to take it away in a retrograde fashion without plate removal. The acetabular cup was first performed with the use of a 58 mm external diameter Trinity cup (Corin, Cirencester, UK) implanting a 40 mm ceramic liner (BIOLOX delta, CeramTec AG, Plochingen, Germany) in order to achieve the most possible stable hip in a patient with such comorbidities. Femoral broaching was performed with the use of an image intensifier in order to avoid cortical perforations. Trial reduction was performed trying to equalize limb lengthening. A number 2 MiniHip stem (Corin, Cirencester, UK) was implanted with a 40 mm ceramic femoral head (BIOLOX delta, CeramTec AG, Plochingen, Germany). Total operative time was 75 minutes. Postoperative radiographs showed no femoral perforations and equalization of limb length. The patient spent 24 hrs in intensive care unit and then started weight-bearing as tolerated with a walker during 2 weeks, followed by a 2-week period with a cane. No clinical complications were observed. Thromboembolic prophylaxis was continued until the 30th postoperative day using enoxaparin 40 mg daily. He was followed up at 45 and 90 days postoperative and then at 1 year, with radiographic signs of both femoral and acetabular bony ingrowth stability (Figures 2(a) and 2(b)) with a functional score of 14 points [1]. Unfortunately, the patient died in another clinic at 19 months postoperative due to a dissecant abdominal aorta aneurism. The family was requested on the hip function and the widow told us he was walking short distances with the use of a cane.


Total hip arthroplasty using a short-stemmed femoral component in the presence of a long dynamic condylar screw osteosynthesis plate.

Buttaro M, Piuzzi N, Comba F, Zanotti G, Piccaluga F - Case Rep Orthop (2014)

Anteroposterior (a) and lateral (b) radiographs of the left hip one year after the conversion to a short-stemmed THA.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4199077&req=5

fig2: Anteroposterior (a) and lateral (b) radiographs of the left hip one year after the conversion to a short-stemmed THA.
Mentions: Removal of this screw was performed in an anterograde way as it is not possible to take it away in a retrograde fashion without plate removal. The acetabular cup was first performed with the use of a 58 mm external diameter Trinity cup (Corin, Cirencester, UK) implanting a 40 mm ceramic liner (BIOLOX delta, CeramTec AG, Plochingen, Germany) in order to achieve the most possible stable hip in a patient with such comorbidities. Femoral broaching was performed with the use of an image intensifier in order to avoid cortical perforations. Trial reduction was performed trying to equalize limb lengthening. A number 2 MiniHip stem (Corin, Cirencester, UK) was implanted with a 40 mm ceramic femoral head (BIOLOX delta, CeramTec AG, Plochingen, Germany). Total operative time was 75 minutes. Postoperative radiographs showed no femoral perforations and equalization of limb length. The patient spent 24 hrs in intensive care unit and then started weight-bearing as tolerated with a walker during 2 weeks, followed by a 2-week period with a cane. No clinical complications were observed. Thromboembolic prophylaxis was continued until the 30th postoperative day using enoxaparin 40 mg daily. He was followed up at 45 and 90 days postoperative and then at 1 year, with radiographic signs of both femoral and acetabular bony ingrowth stability (Figures 2(a) and 2(b)) with a functional score of 14 points [1]. Unfortunately, the patient died in another clinic at 19 months postoperative due to a dissecant abdominal aorta aneurism. The family was requested on the hip function and the widow told us he was walking short distances with the use of a cane.

Bottom Line: We present a potential indication of a short-stemmed femoral component in a patient with multiple comorbidities presenting with hip posttraumatic osteoarthritis and a long dynamic condylar screw osteosynthesis plate.Removal of the plate and implantation of a long stem would have been related to a much longer operative time and potential local or systemic complications.

View Article: PubMed Central - PubMed

Affiliation: The Hip Surgery Unit, Institute of Orthopaedics "Carlos E. Ottolenghi", Italian Hospital of Buenos Aires, Potosí 4247, C1199ACK Buenos Aires, Argentina.

ABSTRACT
We present a potential indication of a short-stemmed femoral component in a patient with multiple comorbidities presenting with hip posttraumatic osteoarthritis and a long dynamic condylar screw osteosynthesis plate. Removal of the plate and implantation of a long stem would have been related to a much longer operative time and potential local or systemic complications.

No MeSH data available.


Related in: MedlinePlus