Revision arthroplasty of femoral cortex defect using a noncemented stem, Mennen plate, and bone graft.

Abstract

Twelve patients who underwent total hip replacement complicated by aseptic loosening with severe bone loss were included in this study. Two patients had aseptic loosening of the second revision, six of the third revision, and the remaining four patients of the fourth revision total hip replacement. In all patients, the radiographs revealed an extremely thin cortex around the stem of the prosthesis and almost complete disappearance of one cortex. All patients were treated by revision total hip replacement in conjunction with Mennen plate fixation and allograft bone support. The allograft bone support included three cortical struts and nine massive bone grafts that used cement as a strew. The results were satisfactory in 10 patients in respect to functional activity, pain and radiographic evaluation. In two patients who underwent their fifth revision, the results were unsatisfactory but better than before the operation. Mennen plate fixation provides a sufficient and easy technique for aseptic loosening of total hip replacement with severe bone loss. By preserving the periosteal blood supply, the time required for bone graft incorporation is shortened, resulting in an early final outcome.