Abstract
Revision total hip arthroplasty (THA) may be indicated for reasons other than femoral loosening.
From 1991 to 1999, 190 revision THA procedures were performed. These included 39 cement-on-cement (20.5%), 68 bone impaction (35.8%), 31 long stem cemented (16.3%), 16 acetabulum only (8.4%), six by-pass prosthesis (3.2%), 20 short stem cemented (10.5%) and 10 miscellaneous revisions (5.3%).
The mean time from previous THA was 6.6 years (1 to 23). Of the cement-on-cement revisions 18 (46%) were done for acetabular loosening, 13 (33.5%) for chronic dislocation, seven (18%) for fracture of the femoral prosthesis and one (2.5%) for chondrolysis of the hemiprosthesis. At a mean short follow-up of three years (1 to 7), we have seen no loosening of the femoral prosthesis.
The absolute indication for this procedure is a Type-A cement mantle in Gruen zones 2 to 6. Cement-on-cement revision can be done only in selected cases, but when possible this technique saves time and money and reduces the perioperative risk.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
