The Wagner cone prosthesis is indicated in uncemented total hip replacement of cases with cylindershaped femurs, deformed femurs, femurs with increased antetorsion, and in conditions of intramedullary bony scar tissue after previous osteotomies. The objective of this study is to present long-term results. From January 1, 1993 to December 31, 1995, 132 implantations were made with the Wagner cone prosthesis. We report the clinical and radiographic results of 94 cone prostheses with a mean observation period of 11.5 years. The Merle d'Aubigné score improved from a preoperative mean value of 8.8 to a postoperative mean of 16.3. The radiographic evaluation revealed 32 cases with cortical hypertrophy, 73 cases with atrophy of the proximal femur, and 18 cases with complete pedestal formation. Radiolucencies over Gruen zones 1 and 7 occurred in 42 cases; only zone 1 was affected in 24 cases. Complications included three deep infections, three acetabular revisions, five total joint revisions, one recurrent luxation, and three heterotopic ossifications. In spite of the fact that the examined cohort often included patients who had undergone multiple previous operations (a maximum of six) of the proximal femur or the acetabulum, the long-term results of the Wagner cone prostheses were very promising.
Thanks to its high primary stability, the concept of threaded cups has gained wide acceptance. The aim of this study is to report the long-term results of the Wagner conical screw cup. Between January 1993 and December 1994, 212 conical screw cup were implanted; 118 implants were clinically and radiographically followed up after a mean of 12.1 years. The Merle d'Aubigné score improved from a preoperative mean of 8.8 to 16.6 postoperatively. Four revisions were performed for heterotopic ossification. Three revisions were done to treat deep infection. Two isolated cup revisions and three more complete total hip joint revisions were required due to aseptic loosening. The overall survival rate at 12 years in this study was 93.2% (110/118); for aseptic loosening alone it was 95.8% (113/ 118). The Wagner conical screw cup by yields very good long-term results.
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