title: Medium-term follow-up of 92 femoral component revisions using a third-generation cementing technique.
abstract: OBJECTIVE
  Very little has been published on the outcome of femoral cemented revisions using a third-generation cementing technique. We report the medium-term outcome of a consecutive series of patients treated in this way.
  
  
  METHODS
  This study included 92 consecutive cemented femoral revisions performed in our department with a third-generation cementing technique and without instrumented bone impaction grafting between 1996 and 2007. The average age of the patients at revision was 66 (25-92) years. None of the patients were lost to follow-up. At review in December 2013, 55 patients were still alive and had a non-re-revised femoral revision component in situ after a mean follow-up of 11 (5-17) years.
  
  
  RESULTS
  The mean preoperative Harris hip score was 50, and improved to 73 at final follow-up. 2 patients died shortly after the revision surgery. 1 stem was re-revised for aseptic loosening; this was also the only case with radiolucent lines in all 7 Gruen zones. A femoral reoperation was performed in 19 hips during follow-up, and in 14 of these 19 reoperations the femoral component was re-revised. Survivorship at 10 years, with femoral re-revision for any reason as the endpoint, was 86% (95% CI: 77-92). However, excluding 8 patients with reinfections after septic index revisions and 1 with hematogenous spread of infection from the survival analysis, the adjusted survival for re-revision for any reason at 10 years was 92% (95% CI: 83-96). With re-revision for aseptic loosening as endpoint, the survival at 10 years was 99% (CI: 90-100).
  
  
  CONCLUSIONS
  Femoral component revision with a third-generation cemented stem results in acceptable survival after medium-term follow-up. We recommend the use of this technique in femoral revisions with limited loss of bone stock.
authors.affiliation: a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands .
authors.forename: Martijn A J
authors.initials: MA
authors.lastname: Te Stroet
authors.affiliation: a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands .
authors.forename: Wim H C
authors.initials: WH
authors.lastname: Rijnen
authors.affiliation: a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands .
authors.forename: Jean W M
authors.initials: JW
authors.lastname: Gardeniers
authors.affiliation: a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands .
authors.forename: Albert
authors.initials: A
authors.lastname: Van Kampen
authors.affiliation: a Department of Orthopaedics , Radboud University Medical Center , Nijmegen , the Netherlands .
authors.forename: B Willem
authors.initials: BW
authors.lastname: Schreurs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002484:Cementation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome