title: The outcome of femoral component revision arthroplasty with impaction allograft bone grafting and a cemented polished Exeter stem: A prospective cohort study of 208 revision arthroplasties with a mean follow-up of ten years.
abstract: We report the clinical and radiographic outcomes of 208 consecutive femoral revision arthroplasties performed in 202 patients (119 women, 83 men) between March 1991 and December 2007 using the X-change Femoral Revision System, fresh-frozen morcellised allograft and a cemented polished Exeter stem. All patients were followed prospectively. The mean age of the patients at revision was 65 years (30 to 86). At final review in December 2013 a total of 130 patients with 135 reconstructions (64.9%) were alive and had a non re-revised femoral component after a mean follow-up of 10.6 years (4.7 to 20.9). One patient was lost to follow-up at six years, and their data were included up to this point. Re-operation for any reason was performed in 33 hips (15.9%), in 13 of which the femoral component was re-revised (6.3%). The mean pre-operative Harris hip score was 52 (19 to 95) (n = 73) and improved to 80 (22 to 100) (n = 161) by the last follow-up. Kaplan-Meier survival with femoral re-revision for any reason as the endpoint was 94.9% (95% confidence intervals (CI) 90.2 to 97.4) at ten years; with femoral re-revision for aseptic loosening as the endpoint it was 99.4% (95% CI 95.7 to 99.9); with femoral re-operation for any reason as the endpoint it was 84.5% (95% CI 78.3 to 89.1); and with subsidence ≥ 5 mm it was 87.3% (95% CI 80.5 to 91.8). Femoral revision with the use of impaction allograft bone grafting and a cemented polished stem results in a satisfying survival rate at a mean of ten years' follow-up.
authors.affiliation: Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: te Stroet
authors.affiliation: Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: W H C
authors.initials: WH
authors.lastname: Rijnen
authors.affiliation: Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: J W M
authors.initials: JW
authors.lastname: Gardeniers
authors.affiliation: Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van Kampen
authors.affiliation: Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: B W
authors.initials: BW
authors.lastname: Schreurs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D019644:Arthroplasty, Replacement, Hip; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome
keywords: Femoral component; Stem; Hip arthroplasty; Impaction bone grafting; Cement; Revision