Surgical Techniques: Extensively Porous-Coated, Cylindrical Stems

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Chapter Synopsis

This chapter reviews the indications and techniques for successful implantation of an extensively porous-coated stem for management of the femoral component in revision hip arthroplasty.

Important Points

Preoperative templating, including on lateral radiographs, is used to determine whether a curved stem is required and to establish the level of an extended osteotomy.
Extended trochanteric osteotomy should be used with little hesitation if needed to aid in implant extraction and safe, accurate femoral preparation.

Clinical/Surgical Pearls

A cerclage wire or cable used distal to the osteotomy before implantation can minimize fracture risk.
Ensuring 4 to 5 cm of scratch-fit helps to optimize the fixation and outcome.

Clinical/Surgical Pitfalls

Failure to adequately prepare the femur (e.g., leaving too much scratch-fit) can increase the risk of fracture during implantation of the prosthesis.

Introduction

Total hip arthroplasty (THA) is one of the most successful interventions in the medical profession. There are many clinical scenarios in which revision arthroplasty is necessary. We review the use of extensively porous-coated, cylindrical stems for management of the femoral component in THA.

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