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Revision total hip replacement with a cemented long femoral component: minimum 9-year follow-up results
Kazutaka So1, Yutaka Kuroda, Shuichi Matsuda
1Department of Orthopaedics, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan. so_kazu@kuhp.kyoto-u.ac.jp
Insights
Revision total hip replacement with a cemented long femoral component shows good long-term outcomes. High-quality cementation is crucial to prevent further loosening and ensure successful revision hip surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Reconstructive Surgery
Background:
- Revision total hip replacement is complex.
- Cemented long femoral components are used for challenging cases.
- Analyzing long-term outcomes and influencing factors is essential.
Purpose of the Study:
- Evaluate long-term results of revision total hip replacement using cemented long femoral components.
- Identify factors impacting the success of these procedures.
- Assess the influence of cement mantle quality on outcomes.
Main Methods:
- Retrospective review of 34 hips in 33 patients (1994-2001).
- Evaluation of hip function using the Japanese Orthopaedic Association scoring system.
- Radiographic assessment for stem loosening and risk factor analysis.
Main Results:
- Mean follow-up of 11.3 years.
- 15-year survival rate of 87% (radiological failure) or 100% (re-revision).
- Good cement mantle quality correlated with significantly higher failure-free survival (p=0.033).
Conclusions:
- Cementation quality is a significant risk factor for femoral component loosening.
- Revision total hip replacement with cemented long femoral components provides satisfactory long-term results.
- Proper cement technique is vital for successful revision hip arthroplasty.
Background:
Surgical revision after failed total hip replacement is a technically challenging procedure. The aim of this study was to analyze the long-term results of revision total hip replacement using a cemented long femoral component and identify factors that influence the results.
Methods:
We retrospectively reviewed 34 hips in 33 patients who had undergone revision total hip replacement using a cemented long femoral component between 1994 and 2001. Hip function was evaluated according to the scoring system of the Japanese Orthopaedic Association. Radiographic examination was performed for evaluation of stem loosening, and its possible risk factors were investigated.
Results:
The mean follow-up duration was 11.3 years (9-15). Perioperative complications included intraoperative femoral cortex perforation (six hips, 18 %), dislocation (five hips, 15 %), deep venous thrombosis (one hip, 3 %) and postoperative periprosthetic fracture (one hip, 3 %). The mean preoperative Japanese Orthopaedic Association hip score was 50.3 ± 14.9 vs 78.2 ± 11.5 at the latest follow-up. The Kaplan-Meier survival rate at 15 years, calculated using radiological failure or re-revision of the femoral component for any reason as the end point, was 87 or 100 %, respectively. The failure-free survival rate for the subgroup with a good-quality cement mantle was significantly higher than that for the subgroup with poor quality (p = 0.033).
Conclusions:
The quality of cementation was identified as a significant risk factor for further loosening. Revision total hip replacement using a cemented long femoral component yielded satisfactory long-term results in this series.
