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THE EXTENSIVELY POROUS COATED FEMORAL STEM IN REVISION HIP ARTHROPLASTY



Abstract

We report the medium term results using an extensively porous coated cementless femoral stem for revision hip arthroplasty in 129 cases.

166 femoral revisions were performed using the Solution cementless stem between 1991 and 1997 in 4 hospitals within our region. 30 patients had died and 7 were lost to follow up leaving 122 patients ( 129 hips ) available for assessment.

All were independently reviewed, questioned about thigh pain, and scored using the Charnley modification of the Postel-D’Aubigne Hip Score. Post operative complications and need for further surgery were noted.

Radiographs were assessed to identify component subsidence, osteolysis and stress shielding.

At mean 5 year follow up (range 2–8 yrs), 9 stems (7%) had been revised and a further 4 stems (3%) were subsiding. Of the remaining components, 8 stems (7%) showed fibrous union and 108 stems (92%) bone ingrowth.

Mild to moderate stress shielding was common but did not seem to affect fixation.

Our findings indicate that satisfactory medium term stability can be achieved using diaphyseal fixation in the mechanically or biologically proximally deficient femur.

Failure due to subsidence occurs due to undersizing, occurs early and progresses.

The abstracts were prepared by Peter Kay. Correspondence should be addressed to him at Centre for Hip Surgery, Wrightington Hospital, Appley Bridge, Wigan WN6 9EP.