Abstract
Introduction: Aseptic loosening is the leading cause of failure in total hip arthroplasty. We present our long-term results of cemented revision of failed total hip replacements.
Materials And Methods: All patients requiring revision for aseptic loosening were prospectively followed up to assess the patterns of failure as well as the clinical and radiological outcomes of revision. There were 102 cases between 1992 and 2000. The mean age at revision was 67.4 (36–88). There were 60 male and 42 female patients. At the time of the final follow-up 26 patients had died and 10 had further surgery. Of the remainder, 64 patients attended the final assessment and 2 could not be traced.
Results: The mean time to follow-up was 6.8 years (5–13 years).
53 patients required revision of both components. There were 49 stem only revisions.
4 patients were re-revised for recurrent loosening and 2 for infection.
There were 14 dislocations. Of these, 4 required secondary stabilisation and 2 underwent Girdlestone’s excision arthroplasty for recurrent dislocation.
46 of the 64 patients who attended final follow-up had no changes in their X-ray appearances compared to the immediately post-operative films. 9 of the stems and 9 of the cups had signs of progressive lucent lines around the cement mantle.
This gives a survivorship of 89% at ten years with reoperation for any cause as the end-point.
Discussion: Initial reported results of cemented revisions were variable. These have been improving with more recent publications including those from the Scandinavian hip registries. Our results confirm the latter findings of excellent survivorship in cemented revisions.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
