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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 263 - 263
1 Mar 2004
Binazzi R Vaccari V Rossi R Marseglia G
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Aims: The purpose of this Paper is to review the preliminary results of a new tapered cementless revision stem, the T3, designed for cases of severe bone stock loss (Paprosky 2b, c and 3) usually representing a difficult challenge for the orthopaedic Surgeon. Methods: The T3 stem is made of Titanium alloy with a textured surface finish. The stem consists of a series of distal conical components to achieve a diaphyseal mechanical stability and 4 proximal bodies. The lateral offset is 42 mm and the cervicodiaphyseal angle is 138°. Between December 1998 and September 2001 we have implanted 22 T3 stems in 22 patients. Indications were severe bone loss in 13 cases, failed but stable cemented/cementless stems in 7 cases and peri-prosthetic fracture in 2. 14 patients were male and 8 female, the average age was 70 years. The average follow-up was 27 mo. In all cases a trans-femoral approach was used. The 7 cases with failed but stable stem showed pre-op a Paprosky 1 bone loss. However in these cases a trans-femoral approach was necessary to remove the stem and then a tapered stem became indispensable; 10 patients showed a Paprosky 2 bone loss (A=3 cases, B=3 cases, C=4 cases) and 5 a Paprosky 3. Post-op management was the same of a primary cementless case with full weight-bearing at 30 days. Results: The average Harris score was 40 points pre-op and 87 post-op. Good and Excellent results were 19(86%), 1 was Fair and 2 Poor (9%). Complications were 2 dislocations reduced conservatively and 1 paresis of Peroneal nerve recovered in 5 months. Bone reconstruction was excellent in 19 cases. 14 cases showed no subsidence and 8 < 5mm. Conclusion: T3 showed excellent preliminary results specially for what concerns bone reconstruction and lack of subsidence.