title: Cemented revision of failed total hip arthroplasty. Survivorship analysis.
abstract: A review of 107 total hip arthroplasties performed with acrylic cement in 89 patients at Columbia-Presbyterian Medical Center by 1 surgeon from 1971 to 1990 revealed a clinical survivorship of 97% at 5 years and 76% at 10 years. The average followup was 7.7 years. Analysis of radiographs revealed a 94% success rate at 5 years and 62% at 10 years. A transtrochanteric approach was used in 99% of procedures. The 13 definite failures (12.1%) included 8 rerevisions (7.5%) and 5 failures (4.6%) pending revision. Modified Merle d'Aubigné and Postel postoperative scores increased significantly from preoperative values (pain, 2.8-5.3 points; movement, 3.2-5.2 points; function, 2.6-5.4 points). Bone grafting was required in 33% of procedures and did not affect survivorship: 24% of procedures required acetabular bone grafts; 4% femoral bone grafts; and 5% acetabular and femoral grafts. In 46% of hips, removal of the original well-fixed femoral cement and plug was deliberately incomplete. Stems of standard length were used for these partially rechannelized femurs because the old distal cement column served as a plug for the canal. Old osseointegrated polymethylmethacrylate was left behind to bond with the new cement column. Cement fracture, complete demarcation, and young age were negatively correlated with survivorship.
authors.affiliation: Department of Orthopaedic Surgery, Lahey Clinic, Burlington, MA 01805, USA.
authors.forename: R
authors.initials: R
authors.lastname: Iorio
authors.forename: N S
authors.initials: NS
authors.lastname: Eftekhar
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: R P
authors.initials: RP
authors.lastname: Grelsamer
mesh_terms: D001843:Bone Cements; D016025:Bone Transplantation; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery; D006622:Hip Prosthesis / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D001843:Bone Cements