Midterm results of the cylindrical fully porous-coated uncemented femoral stem in revision patients with Paprosky I-IIIA femoral defects

Abstract

Introduction: The aim of this study was to analyze the survival of the Echelon (R) femoral stems in revision hip surgeries in patients with Paprosky I-IIIA femoral defects. Patients and methods: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32-83) years, and the mean follow-up period was 93 (45-206) months. The reasons for revision were aseptic loosening in 55 (78.6\%) patients, periprosthetic joint infection in 9 (12.9\%) patients, periprosthetic fracture in 4 (5.7\%) patients, and stem fracture in 2 (2.9\%) patients. The preoperative and postoperative follow-up X-rays and functional scores were evaluated. Results: Five patients died in an average of 70 (45-86) months after surgery due to non-related diseases. We encountered sciatic nerve palsy in two patients and early hip dislocation in two patients, whereas 54 patients were able to walk without any assistive device. The remaining 12 patients required an assistive device to walk. The mean Harris hip score significantly increased from 34 (7-63) preoperatively to 72 (43-96) postoperatively. Aseptic loosening was observed in one patient. The survival of the porous-coated anatomical uncemented femoral stem was 98.4\% over 10 years. Conclusion: This study showed that good clinical outcomes and survival can be obtained when using porous-coated anatomical uncemented femoral stems.