title: Stem subsidence after total hip revision: 183 cases at 5.9 years follow-up.
abstract: BACKGROUND
  Secondary subsidence of a revision femoral stem is often a negative predictive sign for successful osseointegration and perfect long-term stability.
  
  
  METHODS
  We performed a retrospective study in a series of 183 revision total hip replacements between 1996 and 2000 to evaluate the importance and risk factors of secondary subsidence with a cementless press-fit design femoral stem as well as this subsidence's consequences to osseointegration.
  
  
  RESULTS
  Secondary subsidence did not occur in 80 cases (53%), was between 0 and 4mm in 41 cases (27%); between 5 and 10mm in 17 cases (12%) and was greater than 10mm in 12 cases (8%). Mean subsidence of all patients was 3mm (0-30). There was a statistically significant negative correlation between subsidence and the quality of osseointegration (P=0.03). There was no significant relationship between component diameter and stem subsidence (P=0.9). The presence of preoperative bone deficiencies did not increase the risk of secondary subsidence (P=0.2).
  
  
  CONCLUSIONS
  In the case of revision with press-fit stems, the importance of secondary subsidence should not be overestimated, because it usually does not negatively affect satisfactory osseointegration.
authors: Sports and Medicine Unit, North Lille University, 59000 Lille, France. j_girard_lille@yahoo.fr
authors: J
authors: J
authors: Girard
authors: O
authors: O
authors: Roche
authors: G
authors: G
authors: Wavreille
authors: F
authors: F
authors: Canovas
authors: P
authors: P
authors: Le Béguec
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D011183:Postoperative Complications / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome