Purpose: The aim of this study was to evaluate the effectiveness associated with the use of the cementless femoral revision in patients with a previous cemented prosthesis.
Methods: This study reviewed 92 revision femoral stem performed by a single senior surgeon between January 2006 and December 2012 at our institution. All patients complained of unbearable pain before operation, of which 19 cases had extensively porous-coated revision in Paprosky type I or II femoral defects and 73 had modular tapered revision in type IIIA or IIIB defects. All patients had clinical and radiographic follow-up for an average of 3.9 years (range two to seven years), with a mean age of 62.5 years (range 46-86 years) at surgery.
Results: There was no re-revision for loosening. Complications included delayed wound healing in two (2.2 %) patients, dislocation in four (4.3 %), intra-operative femoral fracture in 11 (12.0 %), and periprosthetic fracture postoperatively in three (3.3 %).The average Harris hip scores (HHS) increased from 38.1 (range 20-70) pre-operatively to 82.5 (range 40-95), and the average visual analog scores (VAS) decreased from 8 .3 (range 4-10) pre-operatively to 1.5 (range 0-5) at final follow-up. Radiographic results including stress shielding, subsidence of the stems, bone ingrowth and prosthesis loosening showed that prostheses were stably fixed postoperatively.
Conclusion: This supported that cementless fixation, with the use of extensively porous-coated stems or modular tapered stems, was efficient in patients with a previous failed cemented stem.