The anterior femoral cortical window as an alternative to an extended trochanteric osteotomy in revision hip arthroplasty surgery: the evolution of the surgical technique and outcomes in 22 consecutive cases.
| dc.citation.volume | Ahead of Print | |
| dc.contributor.author | Morley D | |
| dc.contributor.author | Wyatt MC | |
| dc.contributor.author | van Dalen J | |
| dc.coverage.spatial | United States | |
| dc.date.accessioned | 2024-09-24T21:26:13Z | |
| dc.date.available | 2024-09-24T21:26:13Z | |
| dc.date.issued | 2024-08-20 | |
| dc.description.abstract | Background:The anterior femoral cortical window is an attractive alternative to the extended trochanteric osteotomy when removing femoral cement in revision hip arthroplasty. CT-based additive manufacturing technology has now permitted the creation of patient-specific instrumented (PSI) jigs to facilitate this. The jig simplifies creation of the window, potentiating medullary exposure through an optimally-sized window and therefore cement removal. Between 2006 and 2021 this technique was used in 22 cases at a regional hospital in New Zealand (mean age 74; range 44 to 89 years). 16 cases were for aseptic loosening and 6 for infection. We describe the technique and our case series. Bone incorporation for the cortical window was assessed in all cases using CT imaging. Oxford scores were obtained at a minimum of 6 months after revision surgery. Of the 6 septic cases 5 went onto successful stage-2 procedures, the other to a Girdlestone procedure. Results:The mean rectangular shaped window size was 8 × 1.5 cm and in each case, this provided adequate intramedullary access. On average at minimum 5 months post-surgery, 84% bone incorporation of the cortical window occurred on CT (40–100%). The functional outcome Oxford hip score was 37 (range 22–48) for 10 cases. There were 2 cases with femoral component subsidence which then stabilised. Conclusions:This technique description and retrospective case series has shown the effectiveness of removing a distal femoral cement mantle in revision hip arthroplasty using an anterior femoral cortical window, recently optimised using a PSI jig. This technique is a straightforward alternative to a trochanteric osteotomy. Reliable bony integration of the cortical window occurred and functional outcomes were comparable with the mean score for revision hip procedures reported in the New Zealand Joint Registry. | |
| dc.description.confidential | false | |
| dc.format.pagination | 11207000241267704- | |
| dc.identifier.author-url | https://www.ncbi.nlm.nih.gov/pubmed/39164842 | |
| dc.identifier.citation | Morley D, Wyatt MC, van Dalen J. (2024). The anterior femoral cortical window as an alternative to an extended trochanteric osteotomy in revision hip arthroplasty surgery: the evolution of the surgical technique and outcomes in 22 consecutive cases.. Hip Int. Ahead of Print. (pp. 11207000241267704-). | |
| dc.identifier.doi | 10.1177/11207000241267704 | |
| dc.identifier.eissn | 1724-6067 | |
| dc.identifier.elements-type | journal-article | |
| dc.identifier.issn | 1120-7000 | |
| dc.identifier.uri | https://mro.massey.ac.nz/handle/10179/71512 | |
| dc.language | eng | |
| dc.publisher | SAGE Publications | |
| dc.relation.isPartOf | Hip Int | |
| dc.rights | (c) The author/s | en |
| dc.rights.license | CC BY | en |
| dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en |
| dc.subject | Anterior femoral cortical window | |
| dc.subject | bone incorporation | |
| dc.subject | femoral canal cement removal | |
| dc.subject | patient-specific jig | |
| dc.subject | revision hip arthroplasty | |
| dc.subject | trochanteric osteotomy | |
| dc.title | The anterior femoral cortical window as an alternative to an extended trochanteric osteotomy in revision hip arthroplasty surgery: the evolution of the surgical technique and outcomes in 22 consecutive cases. | |
| dc.type | Journal article | |
| pubs.elements-id | 491417 | |
| pubs.organisational-group | College of Health |