Skip to main content
SpringerLink
Log in

Revision total hip arthroplasty by nonmodular short and long cementless stems

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The choice of appropriate implant for reconstruction during revision total hip arthroplasty (THA) is controversial. We use proximally porous-coated cementless short stems and fully porous-coated cementless long stems depending on the state of bone loss during revision surgery.

Methods

Between January 2000 and December 2003, a total of 21 cementless femoral revision arthroplasties using cementless stems were performed, and 20 of the cases were followed up for 2-6 years (mean 4.3 years). Proximally porous-coated cementless short stems were used in 5 cases with minimum bone loss, and fully porous-coated cementless long stems were used in 15 cases with metaphyseal bone loss.

Results

All stems were radiographically stable at the final follow-up. No osteolysis or loosening was seen. None of the patients needed re-revision femoral surgery. Metaphyseal bone loss dramatically diminished in six of nine patients with bypass fixation of the defect lesion by long stems. Bone remodeling of the lost bone occurred in an additional four cases. The mean preoperative Harris Hip Score was 52.7 points, and at the final follow-up examination it was 79.6 points.

Conclusions

Femoral reconstruction during revision THA by short and long cementless stems depending on the degree of bone loss produced a good outcome. To assess long-term durability, it is necessary to follow these cases carefully.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Böhm P, Bischel O. Femoral revision with the Wagner SL revision stem: evaluation of one hundred and twenty-nine revisions followed for a mean of 4.8 years. J Bone Joint Surg Am 2001;83:1023–1031.

    Article  PubMed  Google Scholar 

  2. Blackley HR, Davis AM, Hutchison CR, Gross AE. Proximal femoral allografts for reconstruction of bone stock in revision arthroplasty of the hip: a nine to fifteen-year follow-up. J Bone Joint Surg Am 2001;83:346–354.

    PubMed  Google Scholar 

  3. Roberson JR. Proximal femoral bone loss after total hip arthroplasty. Orthop Clin North Am 1992;23:291–302.

    CAS  PubMed  Google Scholar 

  4. Engelbrecht E. Klassifikation und Behandlungsrichtlinien von Konchensubstanzverlusten bei Revisionsoperationen am Huftgelenk. Mittelfristige Ergebnisse Primare und Revisionsalloarthroplastik Hrsg-Endo-Klinik. Berlin: Springer; 1987. p. 189–201 (in German).

    Google Scholar 

  5. Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 1979;141:17–27.

    PubMed  Google Scholar 

  6. Engh CA Jr, Culpepper WJ 2nd, Engh CA. Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am 1997;79:177–184.

    Article  PubMed  Google Scholar 

  7. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement: the factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br 1987;69:45–55.

    CAS  PubMed  Google Scholar 

  8. Lie SA, Havelin LI, Furnes ON, Engesaeter LB, Vollset SE. Failure rates for 4762 revision total hip arthroplasties in the Norwegian Arthroplasty Register. J Bone Joint Surg Br 2004;86:504–509.

    CAS  PubMed  Google Scholar 

  9. Edwards SA, Pandit HG, Grover ML, Clarke HJ. Impaction bone grafting in revision hip surgery. J Arthroplasty 2003;18:852–859.

    Article  CAS  PubMed  Google Scholar 

  10. Schreurs BW, Arts JJ, Verdonschot N, Buma P, Slooff TJ, Gardeniers JW. Femoral component revision with use of impaction bone-grafting and a cemented polished stem. J Bone Joint Surg Am 2005;87:2499–2507.

    Article  PubMed  Google Scholar 

  11. Cameron HU. The long-term success of modular proximal fixation stems in revision total hip arthroplasty. J Arthroplasty 2002;17:138–141.

    Article  PubMed  Google Scholar 

  12. Kwong LM, Miller AJ, Lubinus P. A modular distal fixation option for proximal bone loss in revision total hip arthroplasty: a 2-to 6-year follow-up study. J Arthroplasty 2003;18:94–97.

    Article  PubMed  Google Scholar 

  13. Walter WL, Walter WK, Zicat B. Clinical and radiographic assessment of a modular cementless ingrowth femoral stem system for revision hip arthroplasty. J Arthroplasty 2006;21:172–178.

    Article  PubMed  Google Scholar 

  14. Böhm P, Bischel O. The use of tapered stems for femoral revision surgery. Clin Orthop 2004;420:148–159.

    Article  PubMed  Google Scholar 

  15. Weeden SH, Paprosky WG. Minimal 11-year follow-up of extensively porous-coated stems in femoral revision total hip arthroplasty. J Arthroplasty 2002;17:134–137.

    Article  PubMed  Google Scholar 

  16. Berry DJ, Harmsen WS, Ilstrup D, Lewallen DG, Cabanela ME. Survivorship of uncemented proximally porous-coated femoral components. Clin Orthop 1995;319:168–177.

    PubMed  Google Scholar 

  17. Malkani AL, Lewallen DG, Cabanela ME, Wallrichs SL. Femoral component revision using an uncemented, proximally coated, long-stem prosthesis. J Arthroplasty 1996;11:411–418.

    Article  CAS  PubMed  Google Scholar 

  18. Mulliken BD, Rorabeck CH, Bourne RB. Uncemented revision total hip arthroplasty: a 4-to-6-year review. Clin Orthop 1996;325:156–162.

    Article  PubMed  Google Scholar 

  19. McAuley JP, Moore KD, Culpepper WJ 2nd, Engh CA. Total hip arthroplasty with porous-coated prostheses fixed without cement in patients who are sixty-five years of age or older. J Bone Joint Surg Am 1998; 80:1648–1655.

    CAS  PubMed  Google Scholar 

  20. Moreland JR, Bernstein ML. Femoral revision hip arthroplasty with uncemented, porous-coated stems. Clin Orthop 1995;319:141–150.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kanazawa Medical University, Ishikawa, Japan

    Hiroaki Kimura, Ayumi Kaneuji, Tanzo Sugimori & Tadami Matsumoto

Authors
  1. Hiroaki Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayumi Kaneuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tanzo Sugimori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tadami Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Kimura, H., Kaneuji, A., Sugimori, T. et al. Revision total hip arthroplasty by nonmodular short and long cementless stems. J Orthop Sci 13, 335–340 (2008). https://doi.org/10.1007/s00776-008-1241-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-008-1241-7

Keywords

Search

Navigation