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The Journal of Bone and Joint Surgery, Vol 76, Issue 7 965-973, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Outcome of revision hip arthroplasty done without cement
JM Lawrence, CA Engh, GE Macalino and GR Lauro
Anderson Orthopaedic Research Institute, Arlington, Virginia 22206.
Between 1980 and 1986, ninety-three femoral revision arthroplasties without
cement were performed on ninety-one patients who had symptomatic loosening
of a stemmed femoral component of a total hip prosthesis. Eighty-one of
these patients (eighty-three hips) were followed for at least five years
(range, five to thirteen years; mean, nine years). Forty-three hips also
had a revision of a cemented acetabular component with use of a
hemispherical, porous-coated implant inserted without cement. The results
are presented in a traditional manner in terms of implant survivorship,
radiographic evaluation for stability of the implant, and standardized hip
scores. Changes due to the treatment are presented as outcomes in terms of
the physician's criteria for the success of the operation, the patient's
criteria for the success of the operation, and the patient's economic
status. No hips that needed additional operations were excluded, and we
reported the outcome regardless of any interim operative procedures
(including re-revisions). At the latest follow-up examination, nineteen (23
per cent) of the eighty-three hips had had an additional operation,
including seventeen hips (20 per cent) for which re-revision had been
necessary. In ten (12 per cent) of the eighty-three hips, the re-revision
had involved an index implant. The rate of re-revision of the index femoral
component was 10 per cent and the rate of mechanical loosening of that
component was 11 per cent. The rate of re-revision of the index acetabular
component was 7 per cent and the rate of mechanical loosening of that
component was 11 per cent.(ABSTRACT TRUNCATED AT 250 WORDS)
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