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Revision total hip replacement using cemented collarless double-taper femoral components
D W Howie1, J A Wimhurst, M A McGee
1Department of Orthopaedics and Trauma, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA 5000, Australia. donald.howie@adelaide.edu.au
The Journal of Bone and Joint Surgery. British Volume
|August 4, 2007
Summary
This study shows that long collarless double-taper cemented femoral components are reliable for revision total hip replacement (THR) in older patients, with high survival rates and fewer complications.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Geriatric Medicine
Background:
- Revision total hip replacement (THR) addresses failed primary hip implants.
- Collarless double-taper cemented femoral components offer potential advantages in revision THR.
- Assessing the long-term outcomes of these specific components is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the survival and clinical outcomes of collarless double-taper cemented femoral components in revision THR.
- To compare the performance of long versus standard length stems in this patient cohort.
- To identify factors influencing the success of revision THR with this implant design.
Main Methods:
- Retrospective analysis of 219 revision total hip replacements (THR) in 211 patients.
- Utilizing collarless double-taper cemented femoral components (137 long, 82 standard length).
- Follow-up duration ranged from 2 to 18 years, with no loss to follow-up.
Main Results:
- Nine-year survival to re-revision for aseptic loosening was 98% for long stems and 93% for standard stems.
- At five years, radiological loosening was observed in one long stem and one standard stem.
- Pre-operative bone deficiency did not impact long stem outcomes; complications like osteotomy, subsidence, stress shielding, and thigh pain were avoided.
Conclusions:
- Cemented long collarless double-taper femoral components demonstrate reliable results in revision THR.
- These components are recommended for routine use in older patients undergoing revision THR.
- The implant design appears to mitigate common complications associated with revision hip surgery.
