Browsing by Author "Dias, RF"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- Stable fixation of a madreporic Lord femoral prosthesis at 31-year follow-up in a total hip arthroplasty: A case reportPublication . Judas, F; Ferreira, JF; Dias, RF; Lucas, FMINTRODUCTION: Lord total hip prosthesis was discontinued due to high revision rates of the smooth threaded acetabular component and negative effects of stress shielding in the proximal femur. PRESENTATION OF CASE: We report the outcome of a Lord cementless femoral stem, in a 55-year-old woman. In 1984, the patient underwent a Lord total hip arthroplasty for the treatment of advanced dysplastic osteoarthritis of the left hip. After 12 years, the cementless acetabular component of the prosthesis had been revised due to aseptic loosening. An acetabular metallic support ring and a cemented polyethylene cup were implanted, the femoral stem was not changed. The acetabular bone loss was reconstructed with morsellised cancellous bone allografts by the impacting technique. No complications were reported during the period of 19 years of the postoperative course. At the last clinical and radiological evaluations, the patient presented an asymptomatic hip and expressed high degree of satisfaction with the surgery result. The femoral stem was stable, with no measurable subsidence or radiolucent lines around the stem. DISCUSSION: Several reports have presented a high clinical success rate with the fully-porous-coated Lord femoral stem in both primary and revision cases. However, the long-term results showed a substantial rate of proximal femoral bone loss and thigh pain. CONCLUSION: In our case, the Lord stem showed an excellent long-term result at the 31-year follow-up. To our knowledge, there is no published report with results of the Lord stem longer than 26-year's follow-up.
- A technique to remove a well-fixed titanium-coated RM acetabular cup in revision hip arthroplastyPublication . Judas, F; Dias, RF; Lucas, FMA major concern during revision hip arthroplasty is acetabular bone loss and bleeding during the extraction of well-fixed cementless acetabular cup, because no interface exists between the host bone and the cup. Forceful removal of such component using curved gouges and osteotomes often leads to extended bone loss and compromises reimplantation of a new socket. In the following case report, we removed a well-fixed polyethylene titanium-coated RM acetabular cup with 20 years of follow-up, by significant wear of the polyethylene layer. The isoelastic femoral stem was also removed by mechanical failure. We report a technique for removal of the cementless acetabular cup using powered acetabular reamers. The RM cup was sequentially reamed and when the polyethylene layer was thin enough, the remaining cup was removed easily by hand tools. The acetabular bone stock is preserved and the risks of bone fractures and bleeding are minimized. To our knowledge, these principles were applied only in cemented cups. We have used this technique in 10 cases with excellent results and no complications were noted. This is a simple, reproducible, non-costly, non-timing consuming, safe and successful technique to remove well-fixed titanium-coated RM acetabular cups.