Femoral revision total hip arthroplasty using a long-stem femoral component. Clinical and radiographic analysis.
Proximal femoral bone stock deficiencies exist during many femoral revision arthroplasties, thus providing inadequate support and fixation for conventional-length cemented femoral components. The authors analyzed the long-term clinical and roentgenographic results of 165 hips requiring femoral revision arthroplasty with a long-stem femoral prosthesis. Intraoperative complications occurred in 23% of hips, with femoral perforations in 16% and femoral fractures in 5%. Of 110 hips with at least 5 years of follow-up study (average, 6.7 years), functional ratings were graded excellent in 34%, good in 36%, fair in 17%, and poor in 13%. Failures occurred in 17 hips (12%) and were attributed to aseptic loosening (11 hips), femoral component fracture (2), femoral shaft fracture (1), and sepsis (3). Symptomatic trochanteric separations occurred in 16% of hips. Rerevision or resection arthroplasty was required in 7 hips (5%) and recommended for another 10 hips (7%). Cemented long-stem femoral components (versus cemented conventional-length stems) decrease the extent and progression of femoral lucencies, thereby lowering the incidence of mechanical failures and improving long-term functional results in cemented femoral revision arthroplasty.
Turner
R H
RH
Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
Mattingly
D A
DA
Scheller
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation
D001843:Bone Cements