A Dispute Around Controversial Crenolanib-Systems

05 or less being considered significant. A Kaplan�CMeier plot with the 95% confidence interval (95% CI) was established to assess the overall stem survival. All the distally locked stems were extracted via the postero-lateral approach with no femoral osteotomy. A single patient experienced an intra-operative femoral fracture during preparation of the femur for implantation of a cemented standard primary stem; this event was managed by implantation of a new Ultime? stem. Mean follow-up was 75?months (range, 3�C188?months). Stem survival at last follow-up Crenolanib research buy was estimated at 72% (95% CI, 47%�C87%) (Fig. 2). Postoperative complications requiring revision surgery occurred in 9 (32%) patients (Table 1): ? two prostheses were removed to treat chronic infection, after 76?months (in a patient with haematogeneous infection) and 3?months (in a patient with a peri-prosthetic fracture as the reason for distally locked stem implantation); Mean follow-up in the 19 patients who still had the standard primary stem was 69?months (range, 13�C152?months). The stem substitution procedure was followed by significant improvements in the clinical scores: the PMA score increased from 11.7 (range, 8�C14) before substitution to 16.7 (range, 13�C18) at last follow-up (P?click here the Hofmann index values 1?cm and 10?cm distal to the lesser trochanter were stable [(36.5% and 51.8% at the time of the substitution procedure, respectively, and 32.9% and 53.5% at last follow-up, respectively (P?=?0.129 and P?=?0.349)]. Peri-prosthetic lucencies were visible in 3 patients; their location, according to Gruen et al. [9] were zone 1; zone 3; and zones 1, 6, and 7; respectively. All 3 patients were free of symptoms. Olaparib Locked femoral stems are widely used in France for THA revision in patients with bone loss and/or peri-prosthetic fractures. The locking stem was initially designed to be replaced by a shorter stem after the occurrence of bone repair [2]?and?[3]. Little information is available, however, on long-to-short stem substitution. We are aware of a single study [4], which had a follow-up of only 4.5?years and only 15 patients. We retrospectively evaluated 29 patients to confirm the feasibility of long-to-short stem substitution and to assess the outcomes of the standard primary stems used for the procedure. The only case of intra-operative femoral fracture occurred during preparation of the femur for a cemented standard stem and not during extraction of the distally locked stem. Our findings confirm the feasibility of the substitution procedure: none of the patients required specific bony procedures and none experienced complications related to locked stem extraction.