Restoration of bone stock in revision surgery of the femur.

Three hundred and four femoral revisions were performed from 1987 to the end of 1990. All were done with cementless titanium calcar replacement prostheses, designed for proximal bone loading. Type III bone deficiencies were present in 160 femurs, all requiring supplemental cortical bone plates for bony augmentation. All grafts united and provided increased bone stock in the long term. Physiologic loading is important for graft remodeling and maturation. Hip scores have improved from an average Harris Hip Score of 44 to 84. Current survivorship at 10 years is 96%, and the revision rate is 3.2%. Thigh pain is mild in 3% of cases. There have been no late failures or distal lysis noted to date.