Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening
Abstract Background Revision of cemented distal femoral replacement (DFR) due to aseptic loosening is challenging because of the resultant femoral bone loss. This paper aims to examine the outcomes of three-dimensional (3D) design custom-made uncemented stems for revision. Methods Between January 20...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03994-0 |
| _version_ | 1797774052659560448 |
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| author | Zhuangzhuang Li Minxun Lu Yong Zhou Li Min Chongqi Tu |
| author_facet | Zhuangzhuang Li Minxun Lu Yong Zhou Li Min Chongqi Tu |
| author_sort | Zhuangzhuang Li |
| collection | DOAJ |
| description | Abstract Background Revision of cemented distal femoral replacement (DFR) due to aseptic loosening is challenging because of the resultant femoral bone loss. This paper aims to examine the outcomes of three-dimensional (3D) design custom-made uncemented stems for revision. Methods Between January 2014 and December 2020, 17 patients received 3D design uncemented stems for revision of loosed cemented DFR. The femoral bone loss was classified into four Grades, and four types of uncemented stems were designed correspondingly. The revision stems were custom-made for each patient by measuring the diameter of the medullary cavity and the anterior curvature of the femur. Results The patient counts with their corresponding Grades of femoral bone loss were as follows: Grade I, 8 patients; Grade II, 5 patients; Grade III, 3 patients; and Grade IV, 1 patient. During the mean follow-up of 80 months, no revision failure was detected. The postoperative radiographic showed that the stem matched the femoral anterior curvature well. The femoral bone defect was completely filled by the 3D design stem in 10 of the 17 cases postoperatively. In the remaining cases, the persistent peri-stem defect was filled or partially restored during the follow-up. Conclusion 3D design custom-made uncemented stem created precise, stable, and durable fixation and provided satisfactory clinical outcomes, which seems to be a viable method for cemented DFR revision. |
| first_indexed | 2024-03-12T22:15:19Z |
| format | Article |
| id | doaj.art-cbdb7f335e544577a3da10a254793520 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-12T22:15:19Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-cbdb7f335e544577a3da10a2547935202023-07-23T11:20:40ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-07-0118111110.1186/s13018-023-03994-0Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic looseningZhuangzhuang Li0Minxun Lu1Yong Zhou2Li Min3Chongqi Tu4Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan UniversityDepartment of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan UniversityAbstract Background Revision of cemented distal femoral replacement (DFR) due to aseptic loosening is challenging because of the resultant femoral bone loss. This paper aims to examine the outcomes of three-dimensional (3D) design custom-made uncemented stems for revision. Methods Between January 2014 and December 2020, 17 patients received 3D design uncemented stems for revision of loosed cemented DFR. The femoral bone loss was classified into four Grades, and four types of uncemented stems were designed correspondingly. The revision stems were custom-made for each patient by measuring the diameter of the medullary cavity and the anterior curvature of the femur. Results The patient counts with their corresponding Grades of femoral bone loss were as follows: Grade I, 8 patients; Grade II, 5 patients; Grade III, 3 patients; and Grade IV, 1 patient. During the mean follow-up of 80 months, no revision failure was detected. The postoperative radiographic showed that the stem matched the femoral anterior curvature well. The femoral bone defect was completely filled by the 3D design stem in 10 of the 17 cases postoperatively. In the remaining cases, the persistent peri-stem defect was filled or partially restored during the follow-up. Conclusion 3D design custom-made uncemented stem created precise, stable, and durable fixation and provided satisfactory clinical outcomes, which seems to be a viable method for cemented DFR revision.https://doi.org/10.1186/s13018-023-03994-0Distal femoral replacementAseptic looseningRevisionUncemented stem3D design |
| spellingShingle | Zhuangzhuang Li Minxun Lu Yong Zhou Li Min Chongqi Tu Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening Journal of Orthopaedic Surgery and Research Distal femoral replacement Aseptic loosening Revision Uncemented stem 3D design |
| title | Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening |
| title_full | Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening |
| title_fullStr | Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening |
| title_full_unstemmed | Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening |
| title_short | Three-dimensional design custom-made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening |
| title_sort | three dimensional design custom made uncemented stem for revision of cemented distal femoral endoprosthesis due to aseptic loosening |
| topic | Distal femoral replacement Aseptic loosening Revision Uncemented stem 3D design |
| url | https://doi.org/10.1186/s13018-023-03994-0 |
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