Wagner 재치환 스템을 이용한 인공 고관절 대퇴 재치환술

Abstract

Purpose: To evaluate the results of revision total hip arthroplasty using a Wagner SL revision stem. Materials and Methods: This study reviewed 56 revisions of the femoral component performed using a Wagner stem in 55 patients between 1992 and 2001. The mean age of the patients at the time of the revision was 50 years. The mean follow up duration was 8.4 years (range, 5 to 12.5 years). The indication for revision was aseptic loosening in fifty-two hips, septic loosening in two and peri prosthetic fractures in two. The pre-revisional femoral defects were classified according to the Paprosky classification system. A clinical evaluation and radiological assessment were performed. Results: The mean Harris hip score improved from 47 points preoperatively to 87 points at the latest follow-up. There were 5, 20, 22 and 9 hips of type Ⅰ, Ⅱ, ⅢA and ⅢB according to the Paprosky classification system. Fifty two hips (93%) showed stable stems at the latest follow-up radiographs. The mean vertical subsidence of the stem was 6.2 ㎜ (range, 0 to 21 ㎜). Severe progressive vertical subsidence in three hips and an infection in one occurred requiring repeat revision. Conclusion: For severe proximal femoral bone loss, the conical femoral revision stem with a fully grit-blasted surface produced satisfactory results with distal press-fit fixation. We can expect a decrease in the rate of mechanical failure rate of the stem by reducing the subsidence derived from the stem design itself.