REVISION TOTAL HIP-ARTHROPLASTY WITH USE OF SO-CALLED 2ND-GENERATION CEMENTING TECHNIQUES FOR ASEPTIC LOOSENING OF THE FEMORAL COMPONENT - A 15-YEAR-AVERAGE FOLLOW-UP-STUDY

We reviewed the results in a consecutive series of forty-three unselec ted hips (forty-one patients) after revision of the femoral component, because of aseptic loosening, with use of so-called second-generation cementing techniques, This series was previously reported on after av erage follow-up intervals of six and 11.7 years; we now report the res ults after an average duration of follow-up of 15.1 years (range, 14.2 to 17.5 years). None of the eight patients (eight hips) who had died before this review had had a reoperation. Over the course of the study period, repeat revision was done after four (11 per cent) of the thir ty-six index procedures that were the first femoral revision and after three of the seven that were a second or third revision, Of the thirt y-five hips in the thirty-three surviving patients, seven (20 per cent ) had a repeat revision of the femoral component because of aseptic lo osening, The average age at the time of the index revision for this gr oup of patients was fifty-one years, This young age has been associate d with distinctly poorer results after revision. In two additional hip s (two patients), there was radiographic evidence of loosening of the femoral component. Therefore, the rate of loosening of the femoral com ponent was 26 per cent (nine of thirty-five hips) at an average of 15. 1 years. These results support the concept that so-called second-gener ation cementing techniques have decreased the prevalence of aseptic lo osening after femoral revision, compared with the shorter-term results that have been reported after revision with use of so-called first-ge neration cementing techniques.