Revision of nonseptic, loose, cemented femoral components using modern cementing techniques.
A series of 43 hips (41 patients) in which a cemented revision arthroplasty was performed for a symptomatic, nonseptic, loose (42) or broken (1) femoral component was reviewed clinically and radiographically. The operation was done using femoral components of contemporary design, a trochanteric osteotomy, a cement gun, and a PMMA femoral plug. The femoral compactor and water pic were used once they became available (36%). The average follow-up period was 74 months (range, 60-111 months). The primary diagnoses included osteoarthritis (52%), CDH (32%), posttraumatic arthritis (6%), AVN (6%), and SCFE (4%). The average age of the patients at the time of the operation that failed was 52.2 years and at revision was 57.4 years. Only one revised cemented femoral component (2% of hips) required rerevision surgery for septic loosening. The average postoperative Harris hip score was 87 points. Four hips (9%) were classified radiographically as definitely loose, one (2%) as probably loose, and one (2%) as possibly loose, but all of these patients had a good or excellent clinical rating. Complications included deep venous thrombosis in 16 patients, trochanteric nonunion in 3 hips, femoral shaft perforations in eight hips, and postoperative dislocations in 6 hips. These techniques appear to represent an improvement over prior techniques.
Rubash
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HE
University of Pittsburgh, Pennsylvania.
Harris
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WH
D002484:Cementation / Q000379:methods; D005260:Female; D005269:Femur; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation