REVISION TOTAL HIP-REPLACEMENT USING THE S-ROM FEMORAL COMPONENT

The proximally porous-coated, modular S-ROM femoral component was used in 52 complex total hip revisions done in 48 patients. These patients had severe bone loss, leg length inequality, and instability. Twenty- two patients required structural femoral allografts; 8 had previous re section arthroplasties for sepsis, The mean number of previous hip ope rations was 3. The stem was press fit, and the metaphyseal sleeve was selectively cemented to the allograft. The preoperative Harris rating was 44 points; at a mean of 3 years, followup was 82 points. Eighty-fo ur percent of the patients were satisfied with their outcomes. No radi ographic or histologic evidence of fretting at the modular sleeve-stem junction or along the stem was seen. Significant thigh pain persisted in 2 patients and was directly related to stem diameters >17 mm. Comp lications in these complex cases were not infrequent, reflecting the n eed for allograft augmentation, and included greater trochanter bursit is and nonunion in 20 hips, minor nonpropagating fracture in 13 hips, and 12 dislocations. Mechanical loosening occurred in 5 hips. There we re no complications attributable to the S-ROM modular femoral componen t, and the prosthesis has proven to be versatile and did well in these very difficult cases.