Revision Total Hip Arthroplasty Using a Modular Cementless Distal Fixation Prosthesis: The Zmr® Hip System. Clinical and Radiographic Analysis of 30 Cases

Abstract

Objective: To evaluate the clinical and radiographic results from 30 cases of revision of total hip arthroplasty using a modular cementless distal fixation prosthesis: the ZMR® Hip System. Method: Between July 2005 and December 2008, 30 operations were performed, on 14 men and 14 women. Two male patients had bilateral surgery. The mean age was 59.2 years (29-81 years), with a mean follow-up of 24 months. The Paprosky classification was used for periprosthetic bone loss, and the Harris Hip Score (HHS) was used to evaluate clinical results. On radiographs, distal migration of the femoral stem was defined in accordance with Sporer. Proximal bone remodeling was classified using the Callaghan criteria. Results: The mean preoperative HHS was 39, and there was a significant increase to 93 points in the final evaluation, which indicated excellent clinical results. No femoral stem migration greater than 5 mm (Sporer) was observed on radiographs, thus suggesting that all the femoral prostheses presented osseointegration and remained stable from the time of the surgery until the final evaluation. The proximal femoral remodeling was either type B or type C in 29 hips, according to Callaghan. Seven patients had complications, but without interfering with osseointegration of the femoral components. Conclusion: Our results from revision of total hip arthroplasty using the ZMR® Hip System were extremely encouraging, and all the components became osseointegrated and remained fixed at the time of the final evaluation.

Mid-term outcomes of titanium modular neck femoral stems in revision total hip arthroplasty

“…First, it is a retrospective study with a small sample size. However, series of revision THA in the literature are usually small (3,23,29,52). Second, though none of the patients showed or reported any adverse reactions or symptoms of metallosis, we did not test serum metal ion levels to demonstrate that these were within normal safe ranges.…”

Clinical, radiographic, and survivorship analysis of a modular fluted tapered stem in revision hip arthroplasty

“…One possible reason for the supposed absence of ALTR with these stems until now is the fact that they are made of titanium alloy, which shows less fretting and crevice corrosion than cobaltchromium-molybdenum implants. 53 Several other modular fluted tapered stems have also demonstrated favorable outcomes in revision arthroplasty at short-to mid-term follow-up, 41,[54][55][56][57][58] indicating that this stem design is useful clinically. It must be emphasized, however, that is not possible to claim that modular fluted tapered stems perform better than other implants in femoral revision arthroplasty.…”