Revision hip surgery using the CLS expansion shell

Authors

ROZKYDAL Zbyněk HAVLÍČEK Vlastimil DEDUCH Jiří JANÍČEK Pavel

Year of publication 2006
Type Article in Periodical
Magazine / Source Hip International
MU Faculty or unit

Faculty of Medicine

Citation
Field Traumatology and orthopaedic surgery
Keywords Total hip replacement - revision
Description Background: The aim of our study is to assess the outcomes using the uncemented CLS Expansion Shell in revision hip surgery for aseptic loosening of acetabular component. Methods: Between 1991 and 2000 we used the CLS expansion shells in revision hip surgery in 215 patients (230 hips). We were able to evaluate 196 patients (211 hips) with failed acetabular component. The male/female ratio was 82/114 and the mean age of the patients was 63 years (range 38-71). The main reason for revision was aseptic loosening of PE cup (184). There were 79 hips with Paprosky defect of the acetabulum type I, 62 hips with type 2A, 57 hips with type 2B and 13 hips with type 2C. in the study. The mean follow-up was 8,5 years (range 5-14). Plain radiographs using an AP view of the pelvis and AP and lateral views of the affected hip were taken immediately after surgery and at the latest follow-up. Clinical outcomes were determined using the Merle d Aubigne and Postel Score and the Harris Hip Score. Results: The mean preoperative Merle d Aubigne Score was 7,8 points (range 6,9 to 9,9); at the latest follow-up it was 14,9 points (range, 12,5 to 15,9). The mean preoperative Harris Hip Score was 38,6 points (range, 32 to 59); at the latest follow-up it was 82,5 points (range, 38 to 95). Osteointegration of the CLS Expansion Shell was present in 149 hips (70,6 %) at the latest follow-up. There were 31 complications (15 %) of the CLS expansion shell requiring a second revision. Clinical survivorship of the CLS expansion shell was 90 % in 5 years and 84 percent in 8,5 years after revision surgery. Radiological survivorship was 78 percent at five years and 70 percent at 8,5 years after revision surgery. Conclusions: The CLS Expansion Shell offers a viable alternative for revision hip surgery with lower bone quality, insufficient bone at the bottom and cavitary defects of the acetabulum.

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