New slide with wmf demograph is TIFF

1
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.
Corey J Richards, MD, MASc, FRCSC Raphael Hau,
MD, FRACS Clive P Duncan, MD, MSc, FRCSC Bassam A
Masri, MD Donald S Garbuz, MD, MHSc. Department
of Orthopaedics, University of British Columbia,
Vancouver, Canada.
2
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.
Disclosure
All authors certify they have not received any
outside funding or grants in support of this
research or preparation of this work. All
authors certify that they, or a member of their
immediate family, has not received any commercial
entity, any payments, or any pecumiary, in kind,
or other professional or personal benefits
including stock, honoraria, or royalties
(collectively, Benefits) or any commitment or
agreement to provide such Benefits.
3
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.

• Cross-sectional, cohort comparison of
• 2 revision femoral component designs
• TFMT Cohort 103 patients treated with a
  tapered, fluted, modular, titanium revision
  femoral stem
• CNCC Cohort 114 patients treated with
  cylindrical, nonmodular, cobalt chromium revision
  femoral stems

4
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.

• Outcome instruments
• Western Ontario McMaster Universities (WOMAC)
  Osteoarthritis Index, Oxford Hip Score, SF-12,
  the Arthroplasty Satisfaction Scale, and UCLA.
• WOMAC scores were normalized on a 0-100 scale
  with 0 being worst and 100 being best. A WOMAC
  score gt75 is considered very good, 65-75 good,
  and below 65 poor.
• Early and minimum 2-year postoperative
  radiographs for evaluation of restoration of
  proximal femoral bone stock
• Intra-operative fracture rate

5
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.
Preoperative Diagnosis
6
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.
Classification of Preoperative Femoral Defects
7
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.

• Results
• Statistically significant higher WOMAC
  stiffness, Womac pain, Oxford scores, and
  Overall Satisfaction scores for the TFMT cohort.
• Statistically significant difference noted for
  radiographically-evident changes to the proximal
  femoral host bone stock with improved osseous
  restoration for the TFMT cohort.
• Significantly less intra-operative fractures for
  the TFMT cohort

8
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.
RESULTS
Quality of Life Outcome Scores
9
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.
RESULTS
P 0.002
Radiographic Evaluation of Restoration for
Proximal Femoral Bone Stock
7 yr F/U
Initial Postop
10
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.
RESULTS
Complications
Intra-operative Fractures TFMT Cohort 9/103
(8.7) CNCC Cohort 29/114 (25.4)
P 0.003
11
Femoral Revision Hip Arthroplasty A Comparison
of Two Stem Designs.

• Conclusions
• This study suggests that TFMT revision components
  are superior to CNCC stems at achieving 3
  important goals of revision femoral surgery
• improved patient quality of life
• restoration of the proximal femur
• decrease complications