THE LONG-TERM RESULTS (MEAN 10.5 YEARS) OF CEMENTED FEMORAL COMPONENTS INSERTED DURING REVISION THA

Abstract

One hundred and thirty-one cemented femoral stems inserted during revision total hip arthroplasty were reviewed to determine component survival. Harris Hip scores and complete radiographs were analysed. Survival at 10.5 years was 86.9%. Radiographically, 76.9% of the remaining components were classified as stable or possibly loose. Chi-square analysis of demographic and surgical factors determined age < 60 years, male gender and stems > 200 mm in length contributed significantly to failure (p < 0.05). Contrary to published results, we found that longer stems were more susceptible to failure. Revision femoral THA to a cemented component is an effective procedure that exhibits good long-term survival.

The purpose of this study was to determine the long-term survival of cemented femoral components in revision total hip arthroplasty (THA) and to identify factors significant to implant failure.

Cemented femoral components demonstrate good long-term survival and remain a suitable option for revision THA for hips with an intact cortical tube.

We report high long-term survival for this increasingly popular procedure, and contradict published results regarding the relationship between stem length and failure.

A consecutive series of one hundred and thirty-one THA revisions using a cemented femoral component were reviewed. Ninety-four hips in eighty-five patients alive > six years post-operatively were studied with a mean follow-up of 10.5 years. Hips excluded from analysis were thirty deceased and seven lost to follow-up before six years post-operatively. Implant success was graded radiographically and by comparing pre-operative to recent Harris Hip scores.

Of the ninety-four hips, fifteen (16%) femoral components were subsequently revised; nine (9.6%) for aseptic loosening, three (3.2%) for periprosthetic fracture, and one (1.1%) for each of stem fracture, instability, and sepsis. Survival at 10.5 years was 86.9% for all reasons and 91.0% for aseptic loosening as an endpoint. 76.9% of the retained components were radiologically classified as stable or possibly loose at follow-up. Factors significant for failure included age at revision < sixty years (p = 0.003), male patients (p = 0.036) and stems > 200 mm in length (p = 0.024).