Abstract
BackgroundThe procedure of femoral stem revision is challenging, and bone conservation with less stress shielding is a mandatory effort in these cases. Although there are several reports of stem revision with stems designed for primary total hip arthroplasty (THA), there is no report on stem revision with the Wagner cone prosthesis.MethodsBetween 1996 and 2008, 41 hips of 41 consecutive patients were subjected to femoral revision THA using the Wagner cone prosthesis. The mean age during revision surgery was 56.1 years, and the mean follow-up period was 14.8 years. The clinical results were evaluated, and the femoral component was assessed radiologically.ResultsThe results showed that the average period from the first operation to revision THA was 8.0 years. Additionally, the mean Harris hip score improved from 52 points preoperatively to 83 points at the final follow-up. All stems showed bone integration in the radiological evaluation. A subsidence of more than 5 mm was observed in 3 out of 28 (10.7%) femoral stems. Two patients needed an acetabular revision for acetabular cup loosening during the follow-up period. Furthermore, one patient had recurrent dislocation and had to undergo revision surgery for soft tissue augmentation.ConclusionsWe achieved favorable clinical and radiological long-term outcomes in femoral stem revision using the Wagner cone prosthesis. This cementless femoral stem could be an option for femoral stem revision in cases with relatively good bone stock.
Highlights
The procedure of femoral stem revision is challenging, and bone conservation with less stress shielding is a mandatory effort in these cases
Materials and methods This study evaluated 41 hips of 41 consecutive patients subjected to femoral revision total hip arthroplasty (THA) by a single surgeon using the Wagner cone prosthesis through a posterolateral approach between 1996 and 2008
The average period from the first operation to revision THA was 8.0 years, and component aseptic loosening was an indication for surgery
Summary
The procedure of femoral stem revision is challenging, and bone conservation with less stress shielding is a mandatory effort in these cases. There are several reports of stem revision with stems designed for primary total hip arthroplasty (THA), there is no report on stem revision with the Wagner cone prosthesis. Due to the increasing life-expectancy and the increasing trend of performing total hip arthroplasty (THA) even in young individuals and physically active patients, the number of THAs has risen rapidly, and the revision and re-revision rates are expected to increase proportionally. Revision after failure of femoral components may be technically demanding due to the loss of the periprosthetic bone stock. The cemented prosthesis is not a good choice for femoral stem revision; Edward et al [2] reported that the cemented revision stem showed a higher rate of radiographic failure as compared to the cementless stem in a 20-year follow-up. Different kinds of cementless stems can be chosen based on the femoral
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
