Abstract
The best type of stem fixation for revision hip arthroplasty is still controversial with regard to medium and long tem results. We wanted to ascertain the medium term results of revision hip arthroplasty using cemented collarless polished tapered femoral stem.
Methods: 44 hips in 39 patients (23 female, 16 male) who had revision THR for aseptic loosening with a minimum follow-up of 10 years were reviewed clinically, radiographically and by using the oxford hip score. Flanged cemented polyethylene cup and polished tapered cemented stem were used. Clinical and radiological evidence of failure and revision rates were determined. Details of grafting and reinforcement required at surgery and any complications in the operative and postoperative period were noted.
Results: The mean age of patients was 70 years (range 35–87 years). Femoral component alone was revised in 2 hips and both cup and stem were revised in 42 hips. Impaction grafting for acetabulum was required in 16 hips and for femur in 5 hips. Failure rate, with revision or excision arthroplasty as the end point, was 13.6% (Total 6 hips – cup and stem in 2 hips, cup only in 3 hips and excision arthroplasty with spacer for infection in 1 hip). The survival rate for femoral stem was 93% and for acetabular cup was 86%. Heterotopic ossification was seen in 9 hips, trochanteric bursitis in 5, short term thigh pain in 3. Mean last Oxford hip score was 30.5/60.
Conclusion: Revision hip arthroplasty using cemented tapered polished stem provides good results at 10 – 13 year follow-up.
Correspondence should be addressed to Mr Richard Wallace at Musgrave Park Hospital, 20 Stockman’s Lane, Belfast BT9 7JB, Northern Ireland.
