title: The use of a long stem cemented femoral component in revision total hip replacement: a follow-up study of five to 16 years.
abstract: In this retrospective study, we investigated the results of revision total hip replacement (THR) using a cemented long-stemmed Exeter femoral component, with a minimum length of 205 mm in patients with extensive femoral bone defects. The study included 37 consecutive patients with a mean age of 76 years (39 to 93) and a mean follow-up of nine years (5 to 16). A total of 26 patients (70%) had a pre-operative Endo-Klinik score of 3 or 4. Impaction bone grafting was used in 24 patients (65%). At the time of evaluation, 22 patients (59%) were still alive and were evaluated clinically and radiologically. A total of 14 patients died during follow-up and their data were included until the time of their death. One reconstruction failed after five years and five months owing to recurrent dislocation: the hip was converted to an excision arthroplasty. Intra-operative fractures or fissures were encountered in nine patients (24%), but none occurred during impaction of the bone graft. Post-operative peri-prosthetic fractures occurred in two patients (5%); both were treated with plate fixation. At nine years, survival with the endpoint of all-cause re-revision was 96.3% (95% CI 76.4 to 99.5); including re-operations for any reason, it was 80.7% (95% CI 56.3 to 92.3%). There were no re-revisions for aseptic loosening. The survival of long stem cemented femoral components following revision THR is satisfactory in a fragile population with extensive femoral defects.
authors.affiliation: Radboud University Medical Center , Department of Orthopaedics P.O. Box 9101, Geert Grooteplein zuid 10, 6500 HB, Nijmegen, the Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: Te Stroet
authors.affiliation: Radboud University Medical Center , Department of Orthopaedics P.O. Box 9101, Geert Grooteplein zuid 10, 6500 HB, Nijmegen, the Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Bronsema
authors.affiliation: Radboud University Medical Center , Department of Orthopaedics P.O. Box 9101, Geert Grooteplein zuid 10, 6500 HB, Nijmegen, the Netherlands.
authors.forename: W H C
authors.initials: WH
authors.lastname: Rijnen
authors.affiliation: Radboud University Medical Center , Department of Orthopaedics P.O. Box 9101, Geert Grooteplein zuid 10, 6500 HB, Nijmegen, the Netherlands.
authors.forename: J W M
authors.initials: JW
authors.lastname: Gardeniers
authors.affiliation: Radboud University Medical Center , Department of Orthopaedics P.O. Box 9101, Geert Grooteplein zuid 10, 6500 HB, Nijmegen, the Netherlands.
authors.forename: B W
authors.initials: BW
authors.lastname: Schreurs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements
keywords: Hip revision surgery; Impaction bone grafting; Long femoral component; Long-term outcome; Peri-prosthetic fracture; Survival analysis