Transfemoral implantation of the Wagner SL stem

Warren, P. J.; Thompson, P.; Fletcher, Matt D. A.

doi:10.1007/s00402-002-0424-5

Cited by 44 publications

(7 citation statements)

References 10 publications

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“…The overall dislocation rate (n = 20; 12%) was comparable with published results in equivalent bone-defect situations ( Wagner and Wagner 1993 , Böhm and Bischel 2001 , Warren et al 2002 , Weeden and Paprosky 2002 , Gutierrez et al 2007 ). The potential advantage of modular stems might be the easy possibility of treating recurrent dislocations successfully by altering the anteversion of the neck module and increasing the femoral offset without removing the distally fixed, tapered femoral stem.…”

Section: Discussionsupporting

confidence: 86%

“…We found a Kaplan-Meier survival rate of 97% after a mean follow-up of 10 years. These results appear encouraging compared to reported rates of aseptic loosening of 4–16% for femoral cementless revision THA with extensive porous-coated stems, the Wagner stem and the modular Revitan system ( Wagner and Wagner 1993 , Böhm and Bischel 2001 , Warren et al 2002 , Weeden and Paprosky 2002 , Gutierrez et al 2007 , Fink et al 2009 , Randhawa et al 2009 )…”

Section: Discussionsupporting

confidence: 51%

“…Stem subsidence has been regarded as the major reason for failure of cement-free revision stems ( Patel et al 2010 ). Most subsidence of cementless stems appears to occur during the first year ( Warren et al 2002 , Fink et al 2009 ) as result of an insufficient initial diaphyseal press fit without secondary stabilization ( Lie et al 2004 ).…”

Section: Discussionmentioning

confidence: 99%

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Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem

et al. 2014

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Background and purpose —Due to the relative lack of reports on the medium- to long-term clinical and radiographic results of modular femoral cementless revision, we conducted this study to evaluate the medium- to long-term results of uncemented femoral stem revisions using the modular MRP-TITAN stem with distal diaphyseal fixation in a consecutive patient series.Patients and methods —We retrospectively analyzed 163 femoral stem revisions performed between 1993 and 2001 with a mean follow-up of 10 (5–16) years. Clinical assessment included the Harris hip score (HHS) with reference to comorbidities and femoral defect sizes classified by Charnley and Paprosky. Intraoperative and postoperative complications were analyzed and the failure rate of the MRP stem for any reason was examined.Results —Mean HHS improved up to the last follow-up (37 (SD 24) vs. 79 (SD 19); p < 0.001). 99 cases (61%) had extensive bone defects (Paprosky IIB–III). Radiographic evaluation showed stable stem anchorage in 151 cases (93%) at the last follow-up. 10 implants (6%) failed for various reasons. Neither a breakage of a stem nor loosening of the morse taper junction was recorded. Kaplan-Meier survival analysis revealed a 10-year survival probability of 97% (95% CI: 95–100).Interpretation —This is one of the largest medium- to long-term analyses of cementless modular revision stems with distal diaphyseal anchorage. The modular MRP-TITAN was reliable, with a Kaplan-Meier survival probability of 97% at 10 years.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem

et al. 2014

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“…However, once stable fixation was achieved, it was effective and reliable. The experience with cable reconstruction of the femurs requiring transfemoral osteotomy 14 was similar to that of Warren et al 15 None failed mechanically or allowed the implants to migrate. The only failure of fixation was not related to femoral osteotomy but was caused by unrecognized fracture, and was corrected by femoral component revision after the fracture had healed.…”

Section: Number 429 December 2004mentioning

confidence: 87%

Major Femoral Bone Loss in Revision Total Hip Arthroplasty Treated with Tapered, Porous-Coated Stems

Whiteside¹

2004

Clinical Orthopaedics and Related Research

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Clinical results of revision total hip arthroplasty using fully porous-coated tapered titanium stems to treat severe proximal femoral bone loss were evaluated in a retrospective review of 39 patients (45 hips). The bone was reinforced with cables in 39 hips, and in 14 hips strut allografts were added. Fixation was successful in 44 hips, and one hip required revision to treat undetected fracture and migration of the stem. All the others had radiographic evidence of bone attachment. Neither bone atrophy nor reconstitution was noted. Three patients (3 hips) had mild thigh pain, but the others had no pain related to the femoral component. Eight hips dislocated; one resolved and seven had recurrent dislocation that was treated with a constrained acetabular component, capsulorrhaphy, or liner reorientation. Ten patients (12 hips) used a walker and 10 patients (12 hips) used a cane at the last postoperative visit. Whereas fixation was successful with this surgical technique, complications related to deficiency of the soft tissue structures were common.

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“… 46 Although later studies have suggested slightly higher rates of fraying than this seminal article, excellent rates of osseous union continue to be reported. 45 , 47 …”

Section: Trochanteric Osteotomy Fixationmentioning

confidence: 99%

Trochanteric osteotomy in revision total hip arthroplasty

2020

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Trochanteric osteotomy is a technique that allows expanded exposure and access to the femoral canal and acetabulum for a number of indications. There has been renewed interest in variants of this technique, including the trochanteric slide osteotomy (TSO), extended trochanter osteotomy (ETO), and the transfemoral approach, for both septic and aseptic revision total hip arthroplasty (THA). Osteotomy fixation is crucial for achieving union, and wire and cable-plate systems are the most common techniques. TSO involves the creation of a greater trochanter fragment with preserved abductor attachment proximally and vastus lateralis attachment distally. This technique may be particularly useful in the setting of abductor deficiency or when augmented acetabular exposure is needed. ETO is a posterior-laterally based extensile approach that has been successfully utilized for aseptic and septic indications; most series report a greater than 90% rate of union. The transfemoral approach, as known as the Wagner osteotomy, is an extensile femoral approach and is more anterior-based than the alternate posterior-based ETO. It may be particularly useful for anterior-based approaches and anterior femoral remodelling; rates of union after this approach in most reports have been close to 100%. Cite this article: EFORT Open Rev 2020;5:477-485. DOI: 10.1302/2058-5241.5.190063

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Transfemoral implantation of the Wagner SL stem

Abstract: We recommend the use of Dall-Miles cables for distal cerclage and osteotomy closure for the Wagner prosthesis.

Cited by 44 publications

References 10 publications

Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem

Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem

Major Femoral Bone Loss in Revision Total Hip Arthroplasty Treated with Tapered, Porous-Coated Stems

Trochanteric osteotomy in revision total hip arthroplasty

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