title: Management of bone loss in revision total hip arthroplasty using custom cementless femoral components.
abstract: Forty-seven consecutive revision total hip arthroplasties were performed using porous ingrowth custom-made prostheses designed from plain radiographs and computed tomography scans. At an average follow-up period of 30 months (range, 2-4 years), one revision has been required for loosening. The average Harris pain score was 39 and the average total score was 84 at the last follow-up evaluation. Complications included nine cases (19%) with intraoperatively detected fractures of the proximal femur treated with cerclage wires and seven cases (15%) with subsidence greater than 3 mm. There were no postoperative infections and only two dislocations. At the time of surgery local particulate bone graft was used in all cases. Thirty-four percent required structural graft to restore bone stock; no case required grafting for prosthesis stability. Management of bone loss in total hip arthroplasty using a custom cementless prosthesis appears to provide an attractive alternative to massive bone grafting.
authors.affiliation: Department of Orthopaedic Surgery, Sutter General Hospital, Sacramento, California.
authors.forename: W L
authors.initials: WL
authors.lastname: Bargar
authors.forename: W J
authors.initials: WJ
authors.lastname: Murzic
authors.forename: J K
authors.initials: JK
authors.lastname: Taylor
authors.forename: M A
authors.initials: MA
authors.lastname: Newman
authors.forename: H A
authors.initials: HA
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D016025:Bone Transplantation; D002484:Cementation; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation