Revision of loose cementless femoral prostheses to larger porous coated components.

Abstract

The results of 21 revision hip arthroplasties were reviewed. The indication for each revision was a symptomatically loose porous coated femoral component. The loose stems were all replaced with Anatomic Medullary Locking stems. In 16 of the 21 procedures, the acetabular component also was revised. Complications included two intraoperative femoral fractures, one sciatic nerve palsy, and one case of multiple hip dislocations. The mean Harris Hip Score was significantly improved from a mean of 42 points (range, 23-90 points) preoperatively to a mean of 84 points (range, 59-100 points) 6.3 years after the revision. Ninety-five percent of the patients reported less severe hip pain. Ninety percent had improved walking ability. Eighty-five percent stated that they were satisfied with the results of the revision procedure. No femoral component has shown radiographic or clinical signs of repeat loosening, and none have been rerevised. It was concluded that when a cementless femoral component becomes symptomatically loose, replacing the loose stem with a larger and more extensively porous coated component is a successful method for achieving better implant fixation.