title: Cementless femoral revision in patients with a previous cemented prosthesis.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness associated with the use of the cementless femoral revision in patients with a previous cemented prosthesis.
  
  
  METHODS
  This study reviewed 92 revision femoral stem performed by a single senior surgeon between January 2006 and December 2012 at our institution. All patients complained of unbearable pain before operation, of which 19 cases had extensively porous-coated revision in Paprosky type I or II femoral defects and 73 had modular tapered revision in type IIIA or IIIB defects. All patients had clinical and radiographic follow-up for an average of 3.9 years (range two to seven years), with a mean age of 62.5 years (range 46-86 years) at surgery.
  
  
  RESULTS
  There was no re-revision for loosening. Complications included delayed wound healing in two (2.2 %) patients, dislocation in four (4.3 %), intra-operative femoral fracture in 11 (12.0 %), and periprosthetic fracture postoperatively in three (3.3 %).The average Harris hip scores (HHS) increased from 38.1 (range 20-70) pre-operatively to 82.5 (range 40-95), and the average visual analog scores (VAS) decreased from 8 .3 (range 4-10) pre-operatively to 1.5 (range 0-5) at final follow-up. Radiographic results including stress shielding, subsidence of the stems, bone ingrowth and prosthesis loosening showed that prostheses were stably fixed postoperatively.
  
  
  CONCLUSIONS
  This supported that cementless fixation, with the use of extensively porous-coated stems or modular tapered stems, was efficient in patients with a previous failed cemented stem.
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zeng
authors.forename: Jie
authors.initials: J
authors.lastname: Xie
authors.forename: Mingqing
authors.initials: M
authors.lastname: Li
authors.forename: Shaoru
authors.initials: S
authors.lastname: Lin
authors.forename: Yihe
authors.initials: Y
authors.lastname: Hu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001842:Bone and Bones / Q000601:surgery; D002484:Cementation; D005260:Female; D005269:Femur / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000601:surgery; D016062:Porosity; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation