Revision after failed femoral components may
be technically demanding due to loss of peri-prosthetic bone. This retrospective
study evaluated the long-term results of femoral revision using
the cementless Wagner Self-Locking stem. Between 1992 and 1998,
68 consecutive hips in 66 patients underwent femoral revision using
this implant. A total of 25 patients died from unrelated causes
without further revision; the remaining 41 hips in 41 patients (12 men
and 29 women) with a mean age of 61 years (29 to 80) were reviewed
at a mean follow-up of 13.9 years (10.4 to 15.8). A transfemoral
approach was used in 32 hips. A total of five stems required further
revision because of infection in two, progressive subsidence in
two and recurrent dislocation in one. Four hips had dislocated and
eight stems had subsided ≥ 10 mm. The mean Harris hip score improved
from 33 points pre-operatively to 75 points at final follow-up (p
<
0.001). In all, 33 stems (91.7%) showed radiological signs
of stable bone fixation. The cumulative survival rates at 15.8 years
with femoral revision for any reason and for stem failure as the
endpoints were 92.0% (95% confidence interval (CI) 86.0% to 98.4%)
and 96.6% (95% CI 92.2% to 100%), respectively. The survivorship
with revision and ≥ 10 mm migration of the stem as the endpoint
was 83.6% (95% CI 76.6% to 91.4%). This study shows quite good survival and moderate clinical outcome
when using a monoblock tapered titanium stem for supporting the
regeneration of bone in complex revision hip surgery.