[Bone defects as complication following total hip endoprosthesis implant]

The authors present a relatively short followup study of 129 patients who were treated with cementless revision for loosened previous arthroplasties. Elderly patients with a first revision and good bone stock condition were excluded as were septic failures. All patients were treated with cementless, hollow-designed implants. Following previous THA and, also repeated revisions--nearly all of them using a cemented technique--many of the patients developed mostly acetabular, but also femoral loss of bone stock of various quality. Many of these cases required extensive allogenic bone grafting; some of the cases with severe loss of bone stock in young patients necessitated two-stage surgery. Despite this high rate of allografts, no infection occurred. Five patients were revised again for loosening or for femoral fracture; two patients showed sinking of the femoral component and clinical deterioration. The possibilities and advantages of restoration of the implant bed in destructive, aseptic loosening with demanding bone graft and cementless techniques are encouraged by the early results of the patients remobilization and radiologically recognizable revitalization of bone stock. Long-term follow-up will be necessary to evaluate allograft incorporation exactly.