Revisions with cemented long-stem prostheses

The purpose of this paper was to describe the surgical techniques for removing and replacing failed femoral prosthetic components. We have also tried to develop a rationale for the use of long-stem femoral components to maximize femoral fixation and to protect the femur from future stresses. It is our recommendation that the revision femoral implant should be anchored into at least 100 mm of healthy bone distal to any previous metal, cement, perforation, or fracture. The surgical techniques described are demanding and require careful practice and preparation on the part of the surgical team. Distal intermedullary plugging and precise biphased cementing techniques are advocated to achieve microinterlock in the distal femur and to provide bulk filling of the proximal femur.