Revision of nonseptic, loose, cemented femoral components using modern cementing techniques.

A series of 43 hips (41 patients) in which a cemented revision arthroplasty was performed for a symptomatic, nonseptic, loose (42) or broken (1) femoral component was reviewed clinically and radiographically. The operation was done using femoral components of contemporary design, a trochanteric osteotomy, a cement gun, and a PMMA femoral plug. The femoral compactor and water pic were used once they became available (36%). The average follow-up period was 74 months (range, 60-111 months). The primary diagnoses included osteoarthritis (52%), CDH (32%), posttraumatic arthritis (6%), AVN (6%), and SCFE (4%). The average age of the patients at the time of the operation that failed was 52.2 years and at revision was 57.4 years. Only one revised cemented femoral component (2% of hips) required rerevision surgery for septic loosening. The average postoperative Harris hip score was 87 points. Four hips (9%) were classified radiographically as definitely loose, one (2%) as probably loose, and one (2%) as possibly loose, but all of these patients had a good or excellent clinical rating. Complications included deep venous thrombosis in 16 patients, trochanteric nonunion in 3 hips, femoral shaft perforations in eight hips, and postoperative dislocations in 6 hips. These techniques appear to represent an improvement over prior techniques.