[113 Re-operations to correct loosening of prosthesis shafts - personal experiences and conclusions (author's...

one hundred and thirteen re-operations necessitated by loosening of the prosthesis shaft were analyzed with regard to surgical stress, technique and results. Of these operations to replace the prosthesis shaft, the surgical technique employed depended on the individual situation in 94 cases. In some, the implant and cement cone were removed, in some the medullary space was foragad, and in others single or multiple fenestration was performed. The surgical investment in these 94 operations proved to be especially high. The main disadvantage of individually oriented, partly improvised procedures is that granular tissue remains in the former contact zone between cement cone and bone. Uncovering of the shaft of the femur in a planned procedure employing the fenestration/chiseling method (19 patients) represents a way of cleaning the medullary cavity completely prior to fitting the replacement implant, with a low level of surgical stress. Implants whose shape corresponds as closely of the shaft are preferred to the so-called long-shaft implants. The authors see a considerable improvement in the departure from individually oriented and partially improvised procedures in replacement interventions: the surgical stress imposed by the operation is easier to assess and the safety of the implant renders the chances of success greater.