Revision total hip arthroplasty with cemented femoral component

Abstract

We reviewed retrospectively the results of 28 hips (25 patients) after revision of the femoral component with use of a cemented stem, because of aseptic loosening. The mean duration of follow-up was 4.43 years (range 2-12 years). Over the course of the study period, repeat revision was done in 4 hips after an average of 4.45 years. Three hips had a repeat revision of the femoral component because of aseptic loosening and one for a deep infection. The rate of loosening of the femoral component was 32.4% (9 hips) at an average of 5.22 years. The 5-year survival rate was 76.9% with mechanical failure as end point; and 90% with rerevision of femoral component because of aseptic loosening as end point. The cement mantle was the principal factor, which was signiWcantly associated with a better survival rate of femur Wxation (P < 0.05). No correlation was noted between quality of bone loss at the time of revision, bone graft or the use of long stems, and the survival rate of femoral component. By improving the cementing technique and in selected patients, the use of cemented femoral stem could be a good alternative for aseptic loosening THA.

Point-of-Care Coating of Revision Femoral Stems With Antibiotic-Loaded Calcium Sulfate: Reduction in Infection After 2nd Stage Reimplantation but Not With Aseptic Revisions

“…In registry studies, the survivorship of aseptic revision THA and 2nd stage reimplantation THA for PJI is best when intravenous antibiotics and antibiotic-loaded cement are used concurrently [ 7 ]. However, studies have shown that aseptic loosening rates of cemented revision THA are significant in the intermediate term [ [8] , [9] , [10] , [11] ]. Therefore, in most countries where the financial environment is suitable, cementless implants, which allow for biologic integration, are the preferred choice for aseptic revision and reimplantation THA [ 12 ].…”

Uncemented computer-assisted design-computer-assisted manufacture femoral components in revision total hip replacement

“…2,3 Technical advances in implant design and surgical techniques have improved survival but significant rates of loosening and bone loss have persisted. [4][5][6][7][8][9][10] Complications have also been associated with the use of uncemented femoral components, including subsidence 9,11 and proximal femoral fractures. 12 The variability of the endosteal geometry after removal of the femoral component can make proximal fit and fill difficult to achieve with an 'off the shelf' prosthesis.…”