PurposeThe use of cementless, modular, distally fixed stem in hip revision arthroplasty has increased during the last decades. We aimed to analyze the early and late postoperative complications, re-operation rate, and survival rate of the MP stem operated at our county hospital with relatively limited caseload.MethodsIn this retrospective study, we included 132 hips operated with MP stem between January 2007–2014. An independent observer reviewed patients’ medical records in July 2015 (18–102 months postoperatively, median 52.5) to collect the following data: age, sex, American Society of Anesthesiologists (ASA) class, body mass index, indication of revision, type of operation, early and late complications, re-operation rate, and mortality during study period.ResultsThe commonest indication for MP stem operation was aseptic loosening (72%). We found early and late postoperative complications in 29% of cases. The most common complication was prosthetic dislocation (8%), followed by intra-operative peri-prosthetic fracture (5%). The commonest indication for MP re-operation was soft tissue revision for infection (7%) followed by closed reduction for prosthetic dislocation (6%). We found no correlation between the age, sex, ASA class, and type of operation and the re-operation risk. Only one prosthesis was extracted giving a survival rate for 99% for the study period.ConclusionThis study showed good results of the MP prosthesis with reasonable complication and re-operation rates and negligible extraction rate, indicating the good performance of this implant even when used in the setting of a county hospital with limited caseload.

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Background: Cartilage defects often are treated with different techniques depending on the surgeon’s preferences and technical availability. A more systematic approach is therefore needed as a practical guide for surgeons regarding the choice of a suitable treatment for a particular patient. Methods: A retrospective descriptive study was done on 40 patients operated on with one of the following techniques: arthroscopic microfracture, periosteal transplantation and assisted matrix induced chondrogenesis (AMIC) technique. The average age of patients was 30.5 yr, with a minimum of 12 and a maximum of 54 yr. The average size of the injury was 2.67 cm2, with a minimum of 1 cm2 and a maximum of 6 cm2. The distribution of the injuries was as follows: trochlea 22.5%, medial femoral condyle 45%, patella 30%, and lateral femoral condyle 2.5%. Results: The proportion of patients who were not satisfied was 21% after 1-year follow-up. The proportion of reoperated patients was 12.5%. The proportion of patients operated on previously was 12.5%. The proportion of patients with multiple chondral defects was 7.5%. Younger patients fared better. Conclusions: Microfracture as the primary technique led to the most failures, but because of its simplicity and balanced clinical results, it should be used as the gold standard, especially in younger patients. Open techniques, AMIC, and periosteal transplantation should be reserved as second choice treatments after failure and as a first choice treatment for multiple lesions, larger defects, older patients, and for defects such as osteochondritis dissecans where there is a need for autologous cancellous bone transplantation.