Removal of well-fixed or porous-coated cementless stems in total hip revision arthroplasty.

The removal of well-fixed or porous-coated cementless stems is demanding and associated with a hig perioperative risk to the patient. Only a few surgical techniques have been published about this procedure. We introduce a special, ballistically driven, flexible chisel for the disruption of bone ingrowth or fibrous encapsulation. In six cases the stem removal was successful after 8-15 min (average 12,2 min) without damage to the bone. Reimplantation is possible with standard stems for primary surgery. This surgical technique leads to a predictable procedure, reduces the risk for the patient, the operation time and costs. We are continuing with this technique under supervision by the local Ethics Commission.