Cementless revision of total hip arthroplasty using the anatomic porous replacement revision prosthesis

This study reports the results of revision total hip arthroplasty with the Anatomic Porous Replacement Revision Hip System (Intermedics Orthopedics, Austin, TX) to investigate the value of cementless fixation. Sixty-six hips in 65 patients were followed for a mean of 4.7 years in patients with a mean age of 56 years. Thirty-six patients were categorized as Charnley class A, 16 as class B, and 13 as class C. Forty (61%) of the femurs were classified before surgery as having loss of bone distal to the intertrochanteric line. Thirty-two (48%) of the femurs required augmentation with demineralized strut cortical allografts, 5 (8%) required bulk femoral allografts, and 12 hips (18%) required acetabular allografts. Overall, 4 stems (6%) and 2 acetabular components (4%) required further revision surgery. The reason for further revision in 1 stem and both acetabular components was allograft failure. Fifty-six (85%) hips had excellent or good Harris hip scores. Ninety percent of hips had no or slight pain, and 90% allowed patients to walk with no or slight limp. Those hips that had hydroxyapatite coating added to the porous coating had statistically improved Harris hip scores for both pain and limp. Stable fixation was present in 95% of stems. Demineralized strut grafts healed in 30 of 32 hips. Thirty-nine of 44 noncemented revision sockets had no radiolucent lines and there were no loose components. Cementless fixation was effective for these hips.