title: Mid-term Results of Revision Total Hip Arthroplasty Using Modular Cementless Femoral Stems.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical and radiological results of revision total hip arthroplasty using modular distal fixation stems for proximal femoral deficiency.
  
  
  METHODS
  Forty-five patients (47 hips) were analyzed more than 24 months after revision total hip arthroplasty that used modular distal fixation stems and was performed between 2006 and 2012. There were proximal femoral defects in all cases. Preoperative femoral defect classification revealed Paprosky type II in 31 cases, type IIIA in 7, and type IIIB in 9. The mean duration of follow-up was 53.4 (25-100) months. We evaluated the Harris hip score (HHS), walking ability according to Koval as clinical parameters, stem stability, and stem position change as radiographic parameters. Kaplan-Meier survival analysis was performed.
  
  
  RESULTS
  The average HHS improved form 39.5 points to 91.3 points and walking ability also improved in most cases; all patients had stable fixation of the femoral stem. Postoperative complications included 5 cases of infection and 2 cases of dislocation. The survival rate with the end point of re-revision surgery due to infection or dislocation was 86% after 8-year follow-up.
  
  
  CONCLUSIONS
  Cementless revision total hip arthroplasty using modular femoral stems is useful because the stems can be stably fixed on the diaphyseal portion of the femur, which has relatively good bone quality at mid-term follow-up.
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Hyung-Gyu
authors.initials: HG
authors.lastname: Jang
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Kyung-Jae
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Min
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Hee-Uk
authors.initials: HU
authors.lastname: Ye
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Kyung-Hwan
authors.initials: KH
authors.lastname: Lim
keywords: Bone defect; Hip; Modular femoral stem; Revision arthroplasty