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. We present the clinical and radiological results of femoral components which have undergone multiple CiC revisions with a minimum follow up of 5 years.Introduction
Objective
Reoperation within thirty days after hip fracture surgery is associated with increased mortality, length of stay and cost of care. The United Kingdom National Hip Fracture Database (NHFD) reported a significant increase in the 30-day reoperation rate for patients undergoing surgery for hip fractures in our unit from 2012 to 2014. We audited our data in order to validate this and identify any reversible trends. Between January 2012 and December 2014, 1757 consecutive procedures for hip fracture were performed in our unit. Patients who had a reoperation within 30 days and those recorded as ‘unknown’ under the reoperation category were identified. Patients with hip dislocations were included. Patient demographics, diagnosis, treatment and outcomes were recorded. This was compared with reoperation for all causes after 30 days over a 12-month period.Introduction
Methods
We present the extended follow-up (≥ 20 years)
of a series of fully hydroxyapatite-coated femoral components used in
72 primary total hip replacements (THRs). Earlier results of this
cohort have been previously published. All procedures were performed
between 1986 and 1991. The series involved 45 women and 15 men with
12 bilateral procedures. Their mean age at the time of surgery was
60 years (46 to 80) and the mean duration of follow-up was 22.5
years (20 to 25). At final follow-up, the mean Merle d’Aubigné and
Postel hip scores were 5.5 (4.5 to 6), 3.8 (3.5 to 5) and 3.3 (3.0
to 5.0) for pain, mobility and function, respectively. Of the patients
92% were very satisfied at the time of final follow-up. There were seven revisions: six of the acetabular component for
aseptic loosening and one of both the stem and the acetabular component
for loosening due to deep infection. The survival of this prosthesis
at 22.5 years with revision for any reason as the endpoint was 91.7%
(95% confidence interval (CI) 84 to 99). Survival with aseptic loosening
of the stem as the endpoint was 100% (95% CI 90 to 100). This prosthesis provides pain relief in the long term. Survival
of this component is comparable to the best results for primary
THR with any means of fixation. Cite this article:
We present the 10- to 17-year results of 112 computer-assisted design computer-assisted manufacture femoral components. The total hip replacements were performed between 1992 and 1998 in 111 patients, comprising 53 men and 58 women. Their mean age was 46.2 years (24.6 to 62.2) with a mean follow-up of 13 years (10 to 17). The mean Harris Hip Score improved from 42.4 (7 to 99) to 90.3 (38 to 100), the mean Oxford Hip Score from 43.1 (12 to 59) to 18.2 (12 to 51) and the mean Western Ontario MacMasters University Osteoarthritis Index score from 57.0 (7 to 96) to 11.9 (0 to 85). There was one revision due to failure of the acetabular component but no failures of the femoral component. There were no revisions for aseptic loosening. The worst-case survival in this cohort of custom femoral components at 13.2 years follow-up was 98.2% (95% confidence interval 95 to 99). Overall survival of this series of total hip replacements was 97.3% (95% confidence interval 95 to 99). These results are comparable with the best medium- to long-term results for femoral components used in primary total hip replacement with any means of fixation.
