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. 2012 May;36(5):961-5.
doi: 10.1007/s00264-011-1379-3. Epub 2011 Oct 26.

Revision total hip arthroplasty using a cementless tapered revision stem in patients with a mean age of 82 years

Daniel Neumann  1 , Lothar Dueckelmann, Christoph Thaler, Ulrich Dorn
Affiliations

Revision total hip arthroplasty using a cementless tapered revision stem in patients with a mean age of 82 years

Daniel Neumann et al. Int Orthop. 2012 May.

Abstract

Purpose: A tapered straight cementless stem was used for revision in a group of old and very old patients. We wanted to know whether the use of this implant could achieve satisfactory results despite age and osteoporosis.

Methods: We retrospectively analysed data of 77 elderly patients (77 hips) who underwent revision in cemented and uncemented primary total hip arthroplasties (THA). The patients had a mean age of 82.2 years (range, 75-92 years) at revision surgery. They were monitored for a mean follow up of 7.1 years (range, 5.0-10.2 years). During the minimum follow-up period 11 patients died of unrelated causes, leaving 66 patients (66 hips) for evaluation.

Results: During the period of study three stems failed due to aseptic loosening, three hips dislocated and were successfully treated by closed reduction and bracing. No infection, osteolysis or significant stress shielding around the stems was observed. The survivorship at an average of 7.1-year follow-up was 95.5%.

Conclusions: These results indicate that this stem is an excellent alternative in revision THA in patients of 75 years or older.

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Figures

Fig. 1
Fig. 1
Female patient (79 years) presenting with osteolysis around a cemented stem 13 years after implantation (X-ray of the right hip obtained in January 2001)
Fig. 2
Fig. 2
Same patient as in Fig. 1 three months after revision (May 2001). The anterior window for cement removal was reinforced with one titanium cerclage. Only the tip of the revision implant is in contact with intact bone
Fig. 3
Fig. 3
Same patient as in Fig. 1 seven years after revision (February 2008). The majority of the formerly compromised, osteolytic bone has remodelled and built up around the revision component depicting full osteointegration
See this image and copyright information in PMC

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