Abstract
Twenty cementless total hip revision arthroplasties using Anatomic BR stems were performed in 20 patients. Fourteen patients, with a mean age of 62.6 years (range 41-74years) at time of revision surgery, were followed retrospectively for a minimum of 10years (range 11-15years). Clinical function and radiographic evidence of implant stability were evaluated. Preoperative femoral deficiencies were evaluated radiographically and classified according to Paprosky type as follows: four Type-II, four Type-IIIA, four Type-IIIB, and two Type-IV femurs. Mean preoperative Harris hip score was 46.3 points (range 29-58 points) and improved to 68.8 points (range 45-90 points) at the most recent follow-up examination. Of the 14 patients followed, six had radiographic evidence of subsidence (axial shift of more than 2mm after revision with long-stem components). Component fixation showed bone ingrowth in three (21%) patients, inconclusive evidence of ingrowth in six (43%) patients, suboptimal but stable fixation in three (21%) patients, and unstable fixation in two (14%) patients. Based on these we results, we conclude that even with circumferential proximal porous coating and improved proximal geometry, nonmodular femoral implant stability remains unpredictable following total hip arthroplasty revision.
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