Retrograde Stem Removal Techniques in Revision Hip Surgery

摘要: Total hip replacement has about a 50 year old past. In recent decades the number of revision arthroplasties in developed countries reached 15-20% primary replacements. The average survival for both cemented and uncemented implants is 94-95% at ten years. At end that period they have to be replaced. Removal well femoral stem total arthroplasty technically demanding procedure, which requires knowledge proficiency usage multitude surgical techniques instruments. Experiences with traditional cement removing been published numerous publications (Dennis et al., 1987; Ferguson, 1988; Laffargue 2000; Lauer 2002; Stuhmer, 1987). Femoral component failure fracture rarely seen complication, presents as difficult problem team. Because stress shielding proximal femur, osteolysis often concentrated part whilst distal portion might stable fixed. This eventually leads metal fracture. Although loose fragment relatively straightforward, tip difficult, only feasible result weakening biomechanical properties such fenestration i.e. creating small or larger window (in lateral cortex an extended trochanteric osteotomy (Wagner, 1989). Authors use retrograde technique clinical setting, removal performed nail passed through knee. With this technique, stems broken components possible – when case appropriate technique. Thus further compromise can avoided poor bone stock.