Vv. Raut et al., OUTCOME OF REVISION FOR MECHANICAL STEM FAILURE USING THE CEMENTED CHARNLEY-STEM - A STUDY OF 399 CASES, The Journal of arthroplasty, 11(4), 1996, pp. 405-410
Three hundred ninety-nine cemented stem revision total hip arthroplas
ties performed in cases with mechanical stem failure without infection
and having a minimum follow-up period of 3 years were prospectively s
tudied. Two hundred eighty-three were revised for aseptic stem looseni
ng and 116 were revised for fractured stem. Bone-grafting was not perf
ormed in any of the cases. The average follow-up period was 7 years 5
months. At the last follow-up evaluation 70.4% of the patients were pa
in free and 20.6% had only mild or occasional discomfort. On radiograp
hic evaluation, 31 stems (7.8%) were loose. Thirty-live hips (8.8%) re
quired a rerevision, of which only 20 (5.0%) were for recurrence of me
chanical stem failure. Clinical survivorship of the revised stem was 9
3.9% at 10 years, whereas radiographic survivorship was 91.5% at 10 ye
ars. On radiographic analysis, the mechanical failure rate at the last
follow-up evaluation was greater after revision for fractured stem th
an after revision for aseptic stem loosening. Prerevision femoral cort
ical bone stock did not appear to adversely affect the outcome of the
procedure. The clinical and radiologic results achieved with cemented
stem revision arthroplasty for mechanical stem failure are excellent.