Revision total hip arthroplasty by nonmodular short and long cementless stems.
BACKGROUND
The choice of appropriate implant for reconstruction during revision total hip arthroplasty (THA) is controversial. We use proximally porous-coated cementless short stems and fully porous-coated cementless long stems depending on the state of bone loss during revision surgery.


METHODS
Between January 2000 and December 2003, a total of 21 cementless femoral revision arthroplasties using cementless stems were performed, and 20 of the cases were followed up for 2-6 years (mean 4.3 years). Proximally porous-coated cementless short stems were used in 5 cases with minimum bone loss, and fully porous-coated cementless long stems were used in 15 cases with metaphyseal bone loss.


RESULTS
All stems were radiographically stable at the final follow-up. No osteolysis or loosening was seen. None of the patients needed re-revision femoral surgery. Metaphyseal bone loss dramatically diminished in six of nine patients with bypass fixation of the defect lesion by long stems. Bone remodeling of the lost bone occurred in an additional four cases. The mean preoperative Harris Hip Score was 52.7 points, and at the final follow-up examination it was 79.6 points.


CONCLUSIONS
Femoral reconstruction during revision THA by short and long cementless stems depending on the degree of bone loss produced a good outcome. To assess long-term durability, it is necessary to follow these cases carefully.
Kimura
Hiroaki
H
Department of Orthopaedic Surgery, Kanazawa Medical University, Ishikawa, Japan.
Kaneuji
Ayumi
A
Sugimori
Tanzo
T
Matsumoto
Tadami
T
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005269:Femur / Q000473:pathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation