Revision Total Hip Arthroplasty Using Cementless Long Stem

Yoo, Myung Chul; Cho, Yoon Je; Kim, Kang Il; Chun, Young Soo; Park, Jun Young

Abstract

PURPOSE
This study evaluated the clinical and radiographic results of patients who received revision total hip arthroplasty (THA) using an anatomic BR and BIAS cementless long stem. MATERIALS AND METHODS: This study was based on 46 cases involving 42 patients who received revision THA using a cementless long stem between October 1988 and August 1998. The average follow-up period was 8 years and 6 months. The Harris hip score and thigh pain were analyzed to evaluate the postoperative result and the changes around the femoral stem were observed radiologically. RESULTS: The Harris hip score improved from an average of 60.7 to 90.8 at the last follow up with no significant difference between the Anatomic BR stem and the BIAS stem. There were 12 cases of osteolysis, 9 cases of calcar resorption, 8 cases of pedestal formation, and 5 cases of vertical subsidence. An obvious spot weld around the stem was observed in 11 cases who received an anatomic BR stem and 7 cases who received a BIAS stem but there was no significant difference between the two. Five cases who received a BIAS stem developed vertical subsidence >5 mm. The complications encountered included 12 cases of femoral cracks intraoperatively and 2 cases of aseptic loosening. CONCLUSION: The cementless long stem, which has a circumferential and widely proximal porous coating, showed accelerated bony ingrowth and eventual stable fixation. This indicated that a cementless long stem would be better when the stem has a wider and circumferentially porous coated surface.