Revision total hip arthroplasty. Long-term results without cement

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Reconstructive Surgery

Background:

• Revision hip arthroplasty is complex, often requiring advanced fixation techniques.
• Cementless implants offer potential advantages in long-term stability for revision cases.
• Previous studies show variable outcomes for revision arthroplasty, necessitating further research into cementless options.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of cementless femoral revision arthroplasty using extensively porous coated implants.
• To assess the revision rate, mechanical failure rate, and patient-reported functional improvements.
• To compare the efficacy of this cementless approach with traditional cemented revision arthroplasty.

Main Methods:

• Prospective follow-up of patients undergoing cementless femoral revision arthroplasty.
• Utilized extensively porous coated femoral implants.
• Data collection included revision rates, radiographic loosening, and patient-reported pain, walking status, and functional levels.
• Follow-up duration ranged from 5 to 11 years (mean 7.4 years).

Main Results:

• Low revision rate of 5.7% and radiographic loosening rate of 1.1%.
• Overall mechanical failure rate was 6.9%.
• Significant patient-reported improvements: 89.1% in pain, 82.8% in walking status, and 88.5% in functional level.
• Outcomes favorably compare to cemented revision arthroplasty reports.

Conclusions:

• Cementless femoral revision arthroplasty with extensively porous coated implants demonstrates favorable short- to mid-term clinical and radiographic results.
• This technique offers a low mechanical failure rate and substantial functional improvement for patients.
• The findings suggest this approach is a viable alternative to cemented techniques in revision hip surgery.