Abstract
Introduction
Revision of well cemented femoral components in revision THA can be technically challenging and time consuming. The cement in cement (CiC) technique addresses these issues. Results of femoral components which have undergone multiple CiC revisions have not previously been reported.
Objective
We present the clinical and radiological results of femoral components which have undergone multiple CiC revisions with a minimum follow up of 5 years.
Methods
Forty nine revision procedures were performed in 24 patients (10 males, 14 females). Seven patients died due to unrelated causes. The outcomes of all patients are known.
Functional assessment were performed using the original Oxford Hip Score (OHS), Harris Hip Score (HHS) and the Merle d'Aubigne Postel(MDP) score. Statistical analysis was performed using the unpaired student's t-test. The level of significance was set at p=0.05.
Radiographs were reviewed for signs of loosening at each visit.
Results
The mean age was 67.5 years. Average duration of follow up was 81.7 months (range 24–240 months). Forty one revision procedures were performed for acetabular revision (the stem was removed to facilitate exposure), 6 were for revision of both components and 2 were isolated stem revisions. Each patient had undergone an average of 2 revision procedures. Four revisions were performed for infection.
Mean preoperative Harris, Oxford and Merle D'Aubigne Postel scores were 38 (Range 3–44), 43 (Range 27–56) and 7 (Range 3–13) respectively.
Average post-operative Harris, Oxford and Merle D'Aubigne Postel scores were 68 (Range 45–70) (p=0.0199), 31 (Range 12–56) (p=0.0397) and 13 (Range 4–18)(p=0.0423) respectively.
There were no signs of loosening follow up.
Conclusion
Cement in cement femoral revision is an effective technique for patients requiring multiple revisions of a well fixed cemented stem. It is associated with pain relief and significant functional improvement in the medium term.
