title: [Revision total hip arthroplasty using a cementless prosthesis].
abstract: OBJECTIVE
  To assess the operative technique and results with the usage of cementless prosthesis in hip revision.
  
  
  METHODS
  Retrospective study was done on revision of total hip arthroplasty with cementless prosthesis in 72 patients (41 males and 31 females) with an average age of 65.7 years (28-82 years) from January 2004 to December 2009. The reason for revision was 2 infection, 54 aseptic loosening, 4 periprosthetic fractures, 5 fracture of femoral stems and 7 cases of acetabular abrasion after hemi-arthroplasty. The operation time, bleeding loss, complications of infection, dislocation, periprosthetic fractures and loosening were evaluated. The Harris score were used for hip function evaluation.
  
  
  RESULTS
  The average operation time was (146±47) minutes (70-280 minutes) and bleeding loss during the operation was (970±540) ml (200-2500 ml). Bacterium cultivation during operation demonstrated infection in 2 patients. Bone windows at the lateral femoral were opened in 4 patients and extend trochanteric osteotomy was done in 7 patients. Fracture of the proximal femur occurred in 8 cases. Twenty-nine patients were treated with bone graft including 18 autografts and 11 allografts. Sixty-seven patients were followed up for an average time of 66 months (20-92 months). Additional revisions were performed in 3 cases including 2 dislocations and 1 infection. There were no death, no damage of major blood vessels and nerves. The bone graft healed during 3-5 months. The survival rates of the femoral prosthesis and the acetabulum prostheses were 95.5% and 98.4%. The mean Harris score was 86±8 (55-95 points). Osteolysis were seen in 13 hips but migration was seen in only 1 patient.
  
  
  CONCLUSIONS
  The cementless prosthesis is useful in revision total hip arthroplasty and the perfect clinical results are related to the reliable primary fixation.
authors.affiliation: Department of Orthopedics, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210008, China. qingj@nju.edu.cn
authors.forename: Qing
authors.initials: Q
authors.lastname: Jiang
authors.forename: Zhi-hong
authors.initials: ZH
authors.lastname: Xu
authors.forename: Dong-yang
authors.initials: DY
authors.lastname: Chen
authors.forename: Dong-quan
authors.initials: DQ
authors.lastname: Shi
authors.forename: Jiang-hui
authors.initials: JH
authors.lastname: Qin
authors.forename: Jin
authors.initials: J
authors.lastname: Dai
authors.forename: Wen-jie
authors.initials: WJ
authors.lastname: Weng
authors.forename: Tao
authors.initials: T
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001705:Bioprosthesis; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies