title: Extensively porous-coated femoral revision for severe femoral bone loss: minimum 10-year follow-up.
abstract: Of 275 femoral revisions done at our institution from 1982 to 1986, we identified 34 patients (35 hips) who represented the senior author's (C.A.E., Sr.) most difficult revision cases as a result of extensive femoral bone loss at least 10 cm below the lesser trochanter. The patients were revised with fully porous-coated femoral components >or=190 mm. We evaluated 25 of the patients (26 hips) who had a minimum 10-year follow-up (mean, 13.3 years). Survivorship was 89% at 10 years with femoral revision as the endpoint (Kaplan-Meier). The femoral aseptic loosening rate was 15% (4 of 26). Three stems were loose but did not warrant reoperation. One stem was revised for aseptic loosening, 1 was revised for septic loosening, and 1 was revised for a fractured femoral component. Bypassing weak or absent femoral bone with an extensively porous-coated stem is an effective reconstructive technique for patients with extensive femoral bone loss.
authors.affiliation: Anderson Orthopaedic Research Institute, Alexandria, Virginia 22307, USA.
authors.forename: C Anderson
authors.initials: CA
authors.lastname: Engh
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ellis
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Koralewicz
authors.forename: James P
authors.initials: JP
authors.lastname: McAuley
authors.forename: Charles A
authors.initials: CA
authors.lastname: Engh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005269:Femur / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation